Abstract
Considering the lack of studies evaluating the performance of commercially available methods for diagnosis of Clostridioides (Clostridium) difficile infection (CDI) in animals, the present study aimed to assess an immunochromatographic test for detection of glutamate dehydrogenase (GDH) and A/B toxins of C. difficile, also evaluated by an ELISA kit, in foals and neonatal piglets. Intestinal contents of 47 piglets and feces of 35 foals were tested to GDH antigen and A/B toxins in a lateral flow method (Ecodiagnostica, Brazil). Also, these samples were submitted to A/B toxin detection by an ELISA kit (C. difficile Tox A/B II, Techlab Inc., USA), using the toxigenic culture (TC) as the reference method. The GDH component of the lateral flow test showed sensitivity and negative predictive value (NPV) of 100% and a high specificity in samples of piglets (82.61%) and foals (100%). Detection of A/B toxins using the lateral flow test and the ELISA resulted in a specificity of 100% in samples of both species. On the other hand, the sensibility ranged from 54.2 to 90% for the ELISA and from 12.5 to 60% for the lateral flow test for piglets’ and foals’ samples, respectively. In conclusion, the present work suggests that the lateral flow test for GDH detection could be a useful method for diagnosing CDI in these species. On the other hand, the low sensitivity of the lateral flow test for A/B toxins might compromise its utility in piglets.
Data availability
The datasets generated during the current study are available from the corresponding author on reasonable request.
References
Czepiel J, Dróżdż M, Pituch H, Kuijper EJ, Perucki W, Mielimonka A, Goldman S, Wultańska D, Garlicki A, Biesiada G (2019) Clostridium difficile infection: review. Eur J Clin Microbiol Infect Dis 38:1211–1221. https://doi.org/10.1007/s10096-019-03539-6
Wilkins TD, Lyerly DM (2003) Clostridium difficile testing: after 20 years, still challenging. J Clin Microbiol 41:531–534. https://doi.org/10.1128/JCM.41.2.531-534.2003
Andrés-Lasheras S, Martín-Burriel I, Mainar-Jaime RC, Morales M, Kuijper E, Blanco JL, Chirino-Trejo M, Bolea R (2018) Preliminary studies on isolates of Clostridium difficile from dogs and exotic pets. BMC Vet Res 14:77. https://doi.org/10.1186/s12917-018-1402-7
Weese JS (2020) Clostridium (Clostridioides) difficile in animals. J Vet Diagn Investig 104063871989908. https://doi.org/10.1177/1040638719899081
Rodriguez C, Taminiau B, Van Broeck J, Delmée M, Daube G (2016) Clostridium difficile in food and animals: a comprehensive review. Adv Microbiol Infect Dis Public Health 932:65–92. https://doi.org/10.1007/5584_2016_27
Silva ROS, Ribeiro MG, Palhares MS, Maranhão RPA, Silva MX, Lucas TM, Olivo G, Lobato FCF (2013) Detection of A/B toxin and isolation of Clostridium difficile and Clostridium perfringens from foals. Equine Vet J 45:671–675. https://doi.org/10.1111/evj.12046
Hensgens MPM, Keessen EC, Squire MM, Riley TV, Koene MGJ, de Boer E, Lipman LJA, Kuijper EJ (2012) Clostridium difficile infection in the community: a zoonotic disease? Clin Microbiol Infect 18:635–645. https://doi.org/10.1111/j.1469-0691.2012.03853.x
McDonald LC, Gerding DN, Johnson S, Bakken JS, Carroll KC, Coffin SE, Dubberke ER, Garey KW, Gould CV, Kelly C, Loo V, Shaklee Sammons J, Sandora TJ, Wilcox MH (2018) Clinical practice guidelines for Clostridium difficile infection in adults and children: 2017 update by the Infectious Diseases Society of America (IDSA) and Society for Healthcare Epidemiology of America (SHEA). Clin Infect Dis 66:e1–e48. https://doi.org/10.1093/cid/cix1085
Crobach MJT, Planche T, Eckert C, Barbut F, Terveer EM, Dekkers OM, Wilcox MH, Kuijper EJ (2016) European Society of Clinical Microbiology and Infectious Diseases: update of the diagnostic guidance document for Clostridium difficile infection. Clin Microbiol Infect 22:S63–S81. https://doi.org/10.1016/j.cmi.2016.03.010
Cançado GGL, Silva ROS, Nader AP, Lobato FCF, Vilela EG (2018) Impact of simultaneous glutamate dehydrogenase and toxin A/B rapid immunoassay on Clostridium difficile diagnosis and treatment in hospitalized patients with antibiotic-associated diarrhea in a university hospital of Brazil: impact of CDI diagnosis on treatment rates. J Gastroenterol Hepatol 33:393–396. https://doi.org/10.1111/jgh.13901
Silva ROS, Santos RLR, Pires PS, Pereira LC, Pereira ST, Duarte MC, de Assis RA, Lobato FCF (2013) Detection of toxins A/B and isolation of Clostridium difficile and Clostridium perfringens from dogs in Minas Gerais, Brazil. Braz J Microbiol 44:133–137. https://doi.org/10.1590/S1517-83822013005000008
Silva ROS, Salvarani FM, da Cruz Júnior ECC, Pires PS, Santos RLR, de Assis RA, de Guedes RMC, Lobato FCF (2011) Detection of enterotoxin A and cytotoxin B, and isolation of Clostridium difficile in piglets in Minas Gerais, Brazil. Ciênc Rural 41:1430–1435. https://doi.org/10.1590/S0103-84782011005000100
Knight DR, Squire MM, Riley TV (2014) Laboratory detection of Clostridium difficile in piglets in Australia. J Clin Microbiol 52:3856–3862. https://doi.org/10.1128/JCM.01225-14
Keessen EC, Hopman NEM, van Leengoed LAMG, van Asten AJAM, Hermanus C, Kuijper EJ, Lipman LJA (2011) Evaluation of four different diagnostic tests to detect Clostridium difficile in piglets. J Clin Microbiol 49:1816–1821. https://doi.org/10.1128/JCM.00242-11
Weese JS, Staempfli HR, Prescott JF (2001) A prospective study of the roles of Clostridium difficile and enterotoxigenic Clostridium perfringens in equine diarrhoea. Equine Vet J 33:403–409. https://doi.org/10.2746/042516401776249534
Anderson MA, Songer JG (2008) Evaluation of two enzyme immunoassays for detection of Clostridium difficile toxins A and B in swine. Vet Microbiol 128:204–206. https://doi.org/10.1016/j.vetmic.2007.09.022
Silva ROS, de Guedes RMC, Silva MX, Lobato FCF (2013) Evaluation of three enzyme immunoassays and toxigenic culture for diagnosis of Clostridium difficile-associated enteritis in piglets. J Swine Health Prod 21:300–303
Eastwood K, Else P, Charlett A, Wilcox M (2009) Comparison of nine commercially available Clostridium difficile toxin detection assays, a real-time PCR assay for C. difficile tcdB, and a glutamate dehydrogenase detection assay to cytotoxin testing and cytotoxigenic culture methods. J Clin Microbiol 47:3211–3217. https://doi.org/10.1128/JCM.01082-09
Silva ROS, Vilela EG, Neves MS, Lobato FCF (2014) Evaluation of three enzyme immunoassays and a nucleic acid amplification test for the diagnosis of Clostridium difficile-associated diarrhea at a university hospital in Brazil. Rev Soc Bras Med Trop 47:447–450. https://doi.org/10.1590/0037-8682-0100-2014
Silva ROS, Guedes RM de C, Lobato FCF (2012) Clostridium difficile infection: main features and occurrence in domestic species in Brazil. Ciênc Rural 43:73–80 . https://doi.org/10.1590/S0103-84782012005000137
Medina-Torres CE, Weese JS, Staempfli HR (2010) Validation of a commercial enzyme immunoassay for detection of Clostridium difficile toxins in feces of horses with acute diarrhea: C. difficile ELISA for horses. J Vet Intern Med 24:628–632. https://doi.org/10.1111/j.1939-1676.2010.00506.x
Silva ROS, Neves MS, Ribeiro MG, Palhares MS, de Albuquerque Maranhão RP, Faria Lobato FC (2014) Evaluation of three enzyme immunoassays for diagnosis of Clostridium difficile–associated diarrhea in foals. J Equine Vet Sci 34:1032–1035. https://doi.org/10.1016/j.jevs.2014.05.012
Diab SS, Songer G, Uzal FA (2013) Clostridium difficile infection in horses: a review. Vet Microbiol 167:42–49. https://doi.org/10.1016/j.vetmic.2013.03.032
Chapman AM (2009) Acute diarrhea in hospitalized horses. Vet Clin North Am Equine Pract 25:363–380. https://doi.org/10.1016/j.cveq.2009.05.001
Diab SS, Rodriguez-Bertos A, Uzal FA (2013) Pathology and diagnostic criteria of Clostridium difficile enteric infection in horses. Vet Pathol 50:1028–1036. https://doi.org/10.1177/0300985813489039
Clooten J, Kruth S, Arroyo L, Weese JS (2008) Prevalence and risk factors for Clostridium difficile colonization in dogs and cats hospitalized in an intensive care unit. Vet Microbiol 129:209–214. https://doi.org/10.1016/j.vetmic.2007.11.013
Weese JS, Armstrong J (2003) Outbreak of Clostridium difficile-associated disease in a small animal veterinary teaching hospital. J Vet Intern Med 17:813–816. https://doi.org/10.1111/j.1939-1676.2003.tb02519
Author information
Authors and Affiliations
Contributions
All authors contributed to the study conception and design. Material preparation and data collection were performed by Emily Oliveira Lopes, Carlos Augusto Oliveira Júnior, and Amanda Nádia Diniz. Analyses were performed by Francisco Carlos Faria Lobato, Rodrigo Otávio Silveira Silva, and Carolina Pantuzza Ramos. The first draft of the manuscript was written by Carolina Pantuzza Ramos, and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.
Corresponding author
Ethics declarations
Experimental methods were approved by the institutional ethics committee (CEUA-UFMG), protocol 013/2014.
Conflict of interest
The authors declare that they have no conflicts of interest.
Statement on the welfare of animals
The present study was performed with fecal samples sent for routine diagnosis of diarrhea. Therefore, this article does not contain any approved ethical committee protocol.
Additional information
Responsible Editor: Miliane Moreira Soares de Souza.
Publisher’s note
Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
Rights and permissions
About this article
Cite this article
Ramos, C.P., Lopes, E.O., Oliveira Júnior, C.A. et al. Immunochromatographic test and ELISA for the detection of glutamate dehydrogenase (GDH) and A/B toxins as an alternative for the diagnosis of Clostridioides (Clostridium) difficile–associated diarrhea in foals and neonatal piglets. Braz J Microbiol 51, 1459–1462 (2020). https://doi.org/10.1007/s42770-020-00275-4
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s42770-020-00275-4