difficle, the most effective and the ones that are used in the contemporary world include culture, cytotoxic assay, enzyme immunoassay, latex agglutination, polymerase chain reaction (PCR), and loop mediated isothermal amplification or LAMP. Each of these diagnostic methods detects varying signs or symptoms for determining the existence of C. difficle. In addition, they have advantages and disadvantages, which may make some desirable as compared to others. Among the diagnostic methods, culture has been the most common for a long time. Culture is mostly used to detect toxigenic and nontoxigenic C. difficle.
This implies that culture can detect two forms of the infection with accuracy. The advantages associated with culture method include that it is sensitive and it allows strain typing in the epidemics. However, it requires aerobic culture. It is not precise for toxin producing bacteria. In addition, it takes some time to get the result. Specifically, it takes between 2 and 5 days to receive the results. Culture has been seen to detect additional 15% of Clostridium difficle cases mostly those that other methods such as direct toxicity neutralization assay or DCNA have missed.
Although culture has been able to detect additional changes of infection and been utilized extensively during the 1970s and 80s, few laboratories continue to utilize culture based methods of diagnosis. According to recent study and research indications, most of the diagnostic methods in use today are non-culture based. This method was being utilized extensively in the past due to the advantage of being sensitive (Kuijper & Wilcox, 2008, p. 64). However, contemporary research has shown that in spite of this method being sensitive, it is not specific for diagnosis.
This is because the nontoxigenic strains linked to C. difficle can be retrieved from samples of stool. These strains are considered not to be pathogenic. Nevertheless, culture, due to its high levels of sensitivity has managed to replace CCCN assay as the preferred method for C. difficle diagnosis. This is in addition to the capability of identifying the production of toxin from pure organism cultures. In spite of this, some researchers still maintain that identification of the toxins in the stool should be the main area of concern rather than detection of the gene that encodes the toxin.
Simply, such researchers are disregarding the effectiveness of this method of diagnostic due to the important fact that it cannot differentiate nontoxin producing from the toxin producing strains.
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