Summary of Available Tests for Clostridium difficile Infection, in Decreasing Order of Sensitivity

 • Toxigenic culture - Sens High, Spec Low, Detects Clostridium difficile vegetative cells or spores

 • Nucleic acid amplification tests - Sens High, Spec  Low/moderate, Detects C. difficile nucleic acid (toxin genes)

 • Glutamate dehydrogenase - Sens High, Spec  Low, Detects C. difficile common antigen

 • Cell culture cytotoxicity neutralization assay - Sens High, Spec High, Detects Free toxins

 • Toxin A and B enzyme immunoassays  - Sens Low, Spec Moderate, Detects Free toxins



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