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Immunological Stability of Clostridium difficile Toxins in Clinical Specimens

Published online by Cambridge University Press:  19 February 2018

Donna M. Schora ,
Lance R. Peterson  and
Elena A. Usacheva
Donna M. Schora
Affiliation:
Infectious Disease Research, NorthShore University HealthSystem, Evanston, Illinois
Lance R. Peterson
Affiliation:
Infectious Disease Research, NorthShore University HealthSystem, Evanston, Illinois Pritzker School of Medicine, University of Chicago, Chicago, Illinois
Elena A. Usacheva*
Affiliation:
Infectious Disease Research, NorthShore University HealthSystem, Evanston, Illinois Pritzker School of Medicine, University of Chicago, Chicago, Illinois
*
Address correspondence to Elena A. Usacheva, PhD, NorthShore University HealthSystem, 2650 Ridge Ave, Walgreen SB #525, Evanston, IL 60201, (EUsacheva@northshore.org).
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Abstract

OBJECTIVE

The impact of storage on stability and detection of Clostridium difficile toxins in feces is poorly understood. The objective of this study was to investigate the immunological stability of C. difficile toxins in clinical stool specimens under different storage conditions by evaluating this stability using toxin detection by enzyme immunoassay (EIA).

METHODS

Stool specimens positive for C. difficile infection (CDI) by quantitative polymerase chain reaction (qPCR) were used for EIA testing with the C. difficile Tox A/B II kit. The EIA-positive specimens were stored aerobically under refrigerated (4–10°C) and frozen (−30°C and −80°C) conditions. Measurement of toxin quantity was conducting using optical density (OD) on days 0, 14, 30, 60, 90, and 120 of storage.

RESULTS

Clostridium difficile toxins demonstrated good detection in undiluted stool specimens by EIA up to 120 days of storage. Good detection of the toxins was observed in diluted samples at refrigerated and −80°C temperatures. Dilution detrimentally affected toxin detection at −30°C.

CONCLUSION

Storage of undiluted clinical stool specimens at refrigerated, −30°C, and −80°C temperatures for up to 120 days has no discernible effect on the immunological stability of C. difficile cytotoxins. However, storage at −30°C has a detrimental effect on C. difficile toxin stability in diluted specimens.

Infect Control Hosp Epidemiol 2018;39:434–438

Type
Original Articles
Information
Infection Control & Hospital Epidemiology , Volume 39 , Issue 4 , April 2018 , pp. 434 - 438
Copyright
© 2018 by The Society for Healthcare Epidemiology of America. All rights reserved 

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Footnotes

PREVIOUS PRESENTATION. These results were presented in part at the Tenth International Society for Applied Biological Sciences (ISABS) Conference on June 19–24, 2017, in Dubrovnik, Republic of Croatia.

References

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