Journal article
Multicenter Evaluation of Clinical Diagnostic Methods for Detection and Isolation of Campylobacter spp. from Stool
Journal of clinical microbiology, Vol.54(5), pp.1209-1215
05/2016
DOI: 10.1128/JCM.01925-15
PMCID: PMC4844741
PMID: 26962088
Abstract
The use of culture-independent diagnostic tests (CIDTs), such as stool antigen tests, as standalone tests for the detection of Campylobacter in stool is increasing. We conducted a prospective, multicenter study to evaluate the performance of stool antigen CIDTs compared to culture and PCR for Campylobacter detection. Between July and October 2010, we tested 2,767 stool specimens from patients with gastrointestinal illness with the following methods: four types of Campylobacter selective media, four commercial stool antigen assays, and a commercial PCR assay. Illnesses from which specimens were positive by one or more culture media or at least one CIDT and PCR were designated "cases." A total of 95 specimens (3.4%) met the case definition. The stool antigen CIDTs ranged from 79.6% to 87.6% in sensitivity, 95.9 to 99.5% in specificity, and 41.3 to 84.3% in positive predictive value. Culture alone detected 80/89 (89.9% sensitivity) Campylobacter jejuni/Campylobacter coli-positive cases. Of the 209 noncases that were positive by at least one CIDT, only one (0.48%) was positive by all four stool antigen tests, and 73% were positive by just one stool antigen test. The questionable relevance of unconfirmed positive stool antigen CIDT results was supported by the finding that noncases were less likely than cases to have gastrointestinal symptoms. Thus, while the tests were convenient to use, the sensitivity, specificity, and positive predictive value of Campylobacter stool antigen tests were highly variable. Given the relatively low incidence of Campylobacter disease and the generally poor diagnostic test characteristics, this study calls into question the use of commercially available stool antigen CIDTs as standalone tests for direct detection of Campylobacter in stool.
Details
- Title: Subtitle
- Multicenter Evaluation of Clinical Diagnostic Methods for Detection and Isolation of Campylobacter spp. from Stool
- Creators
- Collette Fitzgerald - Centers for Disease Control and Prevention, Atlanta, Georgia, USA chf3@cdc.govMary Patrick - Centers for Disease Control and Prevention, Atlanta, Georgia, USAAnthony GonzalezJoshua Akin - Sacramento County Public Health Laboratory, Sacramento, California, USAChristopher R Polage - University of California Davis School of Medicine, Sacramento, California, USAKate Wymore - California Emerging Infections Program, Oakland, California, USALaura Gillim-Ross - Colorado Department of Public Health and Environment, Denver, Colorado, USAKaren Xavier - Colorado Department of Public Health and Environment, Denver, Colorado, USAJennifer Sadlowski - Colorado Department of Public Health and Environment, Denver, Colorado, USAJan Monahan - Exempla St. Joseph Hospital, Denver, Colorado, USASharon Hurd - Connecticut Emerging Infections Program, New Haven, Connecticut, USASuzanne Dahlberg - Yale-New Haven Hospital, New Haven, Connecticut, USARobert Jerris - Children's Healthcare of Atlanta, Atlanta, Georgia, USARenee Watson - Children's Healthcare of Atlanta, Atlanta, Georgia, USAMonica Santovenia - Centers for Disease Control and Prevention, Atlanta, Georgia, USADavid Mitchell - Centers for Disease Control and Prevention, Atlanta, Georgia, USACassandra Harrison - Centers for Disease Control and Prevention, Atlanta, Georgia, USAMelissa Tobin-D'Angelo - Georgia Department of Public Health, Atlanta, Georgia, USAMary DeMartino - State Hygienic Laboratory at the University of Iowa, Iowa City, Iowa, USAMichael Pentella - State Hygienic Laboratory at the University of Iowa, Iowa City, Iowa, USAJafar Razeq - Maryland Department of Health and Mental Hygiene, Baltimore, Maryland, USACelere Leonard - Maryland Department of Health and Mental Hygiene, Baltimore, Maryland, USACarrianne Jung - Maryland Department of Health and Mental Hygiene, Baltimore, Maryland, USARia Achong-Bowe - Maryland Department of Health and Mental Hygiene, Baltimore, Maryland, USAYaaqobah Evans - Maryland Department of Health and Mental Hygiene, Baltimore, Maryland, USADamini Jain - Maryland Department of Health and Mental Hygiene, Baltimore, Maryland, USABillie Juni - Minnesota Department of Health, St. Paul, Minnesota, USAFe Leano - Minnesota Department of Health, St. Paul, Minnesota, USATrisha Robinson - Minnesota Department of Health, St. Paul, Minnesota, USAKirk Smith - Minnesota Department of Health, St. Paul, Minnesota, USARachel M Gittelman - Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USACharles Garrigan - Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USAIrving Nachamkin - Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
- Resource Type
- Journal article
- Publication Details
- Journal of clinical microbiology, Vol.54(5), pp.1209-1215
- Publisher
- United States
- DOI
- 10.1128/JCM.01925-15
- PMID
- 26962088
- PMCID
- PMC4844741
- ISSN
- 1098-660X
- eISSN
- 1098-660X
- Language
- English
- Date published
- 05/2016
- Academic Unit
- Central Control Hygienic Laboratory; Epidemiology
- Record Identifier
- 9983995163202771
Metrics
13 Record Views