The number of case identified or not identified as <i>C. difficile</i> infection.

a<p>The 20 cases included 10 cases that were toxin-positive by the EIA (<a href="http://www.plosone.org/article/info:doi/10.1371/journal.pone.0106102#pone-0106102-t001" target="_blank">Table 1</a>).</p><p>The number of case identified or not identified as <i>C. difficile</i> infection.</p

Performance Characteristics of the Verigene CDF test compared with the PCR following fecal culture.

a<p>CI: confidence interval.</p><p>Performance Characteristics of the Verigene CDF test compared with the PCR following fecal culture.</p

Comparison of the results of an EIA and PCR following fecal culture for detecting <i>C. difficile</i> in fecal specimens.

a<p>The EIA detects <i>C. difficile</i> antigen (GDH) and <i>C. difficile</i> toxin (<i>tcdA</i> and/or <i>tcdB</i>).</p>b<p>Of the 31 GDH-positive samples, 13 were toxin-positive in the EIA.</p>c<p>According to the results of the EIA, the numbers of toxin-positive or -negative samples with PCR following fecal culture are shown.</p>d<p>Numbers of samples negative with either fecal culture or PCR.</p>e<p>Of the 31 GDH-positive samples, 28 were <i>tcdA</i>- and <i>tcdB</i>-positive with PCR following fecal culture.</p>f<p>All 13 samples that were GDH- and toxin-positive with EIA were <i>tcdA</i>- and <i>tcdB</i>-positive with PCR following fecal culture.</p><p>Comparison of the results of an EIA and PCR following fecal culture for detecting <i>C. difficile</i> in fecal specimens.</p

Evaluation of an Automated Rapid Diagnostic Assay for Detection of Gram-Negative Bacteria and Their Drug-Resistance Genes in Positive Blood Cultures

<div><p>We evaluated the performance of the Verigene Gram-Negative Blood Culture Nucleic Acid Test (BC-GN; Nanosphere, Northbrook, IL, USA), an automated multiplex assay for rapid identification of positive blood cultures caused by 9 Gram-negative bacteria (GNB) and for detection of 9 genes associated with β-lactam resistance. The BC-GN assay can be performed directly from positive blood cultures with 5 minutes of hands-on and 2 hours of run time per sample. A total of 397 GNB positive blood cultures were analyzed using the BC-GN assay. Of the 397 samples, 295 were simulated samples prepared by inoculating GNB into blood culture bottles, and the remaining were clinical samples from 102 patients with positive blood cultures. Aliquots of the positive blood cultures were tested by the BC-GN assay. The results of bacterial identification between the BC-GN assay and standard laboratory methods were as follows: <i>Acinetobacter</i> spp. (39 isolates for the BC-GN assay/39 for the standard methods), <i>Citrobacter</i> spp. (7/7), <i>Escherichia coli</i> (87/87), <i>Klebsiella oxytoca</i> (13/13), and <i>Proteus</i> spp. (11/11); <i>Enterobacter</i> spp. (29/30); <i>Klebsiella pneumoniae</i> (62/72); <i>Pseudomonas aeruginosa</i> (124/125); and <i>Serratia marcescens</i> (18/21); respectively. From the 102 clinical samples, 104 bacterial species were identified with the BC-GN assay, whereas 110 were identified with the standard methods. The BC-GN assay also detected all β-lactam resistance genes tested (233 genes), including 54 <i>bla</i>_CTX-M, 119 <i>bla</i>_IMP, 8 <i>bla</i>_KPC, 16 <i>bla</i>_NDM, 24 <i>bla</i>_OXA-23, 1 <i>bla</i>_OXA-24/40, 1 <i>bla</i>_OXA-48, 4 <i>bla</i>_OXA-58, and 6 <i>bla</i>_VIM. The data shows that the BC-GN assay provides rapid detection of GNB and β-lactam resistance genes in positive blood cultures and has the potential to contributing to optimal patient management by earlier detection of major antimicrobial resistance genes.</p></div

Primers used in this study.

<p>Primers used in this study.</p

Identification of bacterial isolates in blood culture samples with the BC-GN assay.

<p>a Bacterial species inoculated into blood culture bottles or bacterial species identified in clinical samples of blood culture bottles.</p><p>b Blood culture samples into which bacterial isolates were inoculated.</p><p>c Clinical blood culture samples obatined from sepsis patients.</p><p>d Numbers of isolates which were correctly identified with the BC-GN assay.</p><p>e Numbers of isolates which were not detected with the BC-GN assay.</p><p>f Numbers of isolates which were incorrectly identified with theBC-GN assay.</p><p>g Numbers of bacterial species which were identified in clinical samples with the conventional methods. Some of the samples contained 2 or 3 bacterial species.</p><p>h Concordance rate between the BC-GN assay and the conventional methods for bacterial identification.</p><p>i CI indicates confidence interval</p><p>j A sample inoculated with K. pneumoniae was identified as Enterobacter spp. with the assay.</p

Bacterial species and Antimicrobial resistance genes identified by the BC-GN assay.

<p>Bacterial species and Antimicrobial resistance genes identified by the BC-GN assay.</p