{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,13]],"date-time":"2026-05-13T22:45:57Z","timestamp":1778712357553,"version":"3.51.4"},"reference-count":19,"publisher":"American Society for Microbiology","issue":"3","license":[{"start":{"date-parts":[[2008,3,1]],"date-time":"2008-03-01T00:00:00Z","timestamp":1204329600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.asm.org\/non-commercial-tdm-license"}],"content-domain":{"domain":["journals.asm.org"],"crossmark-restriction":true},"short-container-title":["Clin Vaccine Immunol"],"published-print":{"date-parts":[[2008,3]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n          <jats:p>\n            <jats:italic>Clostridium difficile<\/jats:italic>\n            causes nosocomial diarrhea and is responsible for complications such as pseudomembranous colitis, megacolon, and perforation. Using 442 stool specimens, we compared the sensitivities and specificities of the Premier toxin A and B (Meridian Bioscience, Inc.) and\n            <jats:italic>C. difficile<\/jats:italic>\n            TOX A\/B II (TechLab, Inc., Blacksburg, VA) immunoassays in the Virology Department of the Kaiser Permanente Regional Reference Laboratories. The Premier toxin A and B assay demonstrated a higher sensitivity (97.44%) and a higher positive predictive value (79.17%) than the\n            <jats:italic>C. difficile<\/jats:italic>\n            TOX A\/B II assay (87.18% and 75.56%, respectively), while assay specificities and negative predictive values were similar. We also performed experiments using serially diluted, purified toxin A and B antigens to understand the basis for assay differences. The two assays\u2019 toxin A antibodies detected toxin A at comparable levels. Preliminary results indicated that the toxin B antibody in the Premier toxin A and B assay could detect toxin B at a concentration of 125 pg\/100 \u03bcl, while the toxin B antibody in the\n            <jats:italic>C. difficile<\/jats:italic>\n            TOX A\/B II assay could not detect toxin B below a concentration of 250 pg\/100 \u03bcl. Therefore, the Premier toxin A and B assay provides greater sensitivity than the\n            <jats:italic>C. difficile<\/jats:italic>\n            TOX A\/B II assay, perhaps due to a superior detection ability of its toxin B antibody.\n          <\/jats:p>","DOI":"10.1128\/cvi.00282-07","type":"journal-article","created":{"date-parts":[[2008,1,3]],"date-time":"2008-01-03T01:59:41Z","timestamp":1199325581000},"page":"575-578","update-policy":"https:\/\/doi.org\/10.1128\/asmj-crossmark-policy-page","source":"Crossref","is-referenced-by-count":16,"title":["Comparison of the Premier Toxin A and B Assay and the TOX A\/B II Assay for Diagnosis of\n            <i>Clostridium difficile<\/i>\n            Infection"],"prefix":"10.1128","volume":"15","author":[{"given":"Susan M.","family":"Novak-Weekley","sequence":"first","affiliation":[{"name":"Kaiser Permanente Regional Reference Laboratories, 11668 Sherman Way, North Hollywood, California 91605"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michele H.","family":"Hollingsworth","sequence":"additional","affiliation":[{"name":"Kaiser Permanente Regional Reference Laboratories, 11668 Sherman Way, North Hollywood, California 91605"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"235","reference":[{"key":"e_1_3_1_2_2","doi-asserted-by":"publisher","DOI":"10.1128\/JCM.40.6.2079-2083.2002"},{"key":"e_1_3_1_3_2","doi-asserted-by":"crossref","first-page":"573","DOI":"10.1136\/jcp.40.5.573","volume":"40","year":"1987","unstructured":"Borriello, S. P., F. E. Barclay, P. J. Reed, A. R. Welch, J. D. Brown, and D. W. Burdon. 1987. Analysis of latex agglutination test for Clostridium difficile toxin A (D-1) and differentiation between C. difficile toxins A and B and latex reactive protein. J. Clin. Pathol.40:573-580.","journal-title":"J. Clin. Pathol."},{"key":"e_1_3_1_4_2","doi-asserted-by":"publisher","DOI":"10.1128\/jcm.9.2.214-219.1979"},{"key":"e_1_3_1_5_2","doi-asserted-by":"crossref","first-page":"434","DOI":"10.7326\/0003-4819-135-6-200109180-00012","volume":"135","year":"2001","unstructured":"Johnson, S., S. A. Kent, K. J. O'Leary, M. M. Merrigan, S. P. Sambol, L. R. Peterson, and D. N. Gerding. 2001. Fatal pseudomembranous colitis associated with a variant Clostridium difficile strain not detected by toxin A immunoassay. Ann. Intern. Med.135:434-438.","journal-title":"Ann. Intern. 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