Medizinische Universität Graz Austria/Österreich - Forschungsportal - Medical University of Graz
Gewählte Publikation:
SHR Neuro Krebs Kardio Lipid Stoffw Microb
Leitner, E; Bozic, M; Kienesberger, S; Cosic, A; Landt, O; Högenauer, C; Kessler, HH.
Improved diagnosis of antibiotic-associated haemorrhagic colitis (AAHC) in faecal specimens by a new qualitative real-time PCR assay detecting relevant toxin genes of Klebsiella oxytoca sensu lato.
Clin Microbiol Infect. 2022; 28(5):690-694
Doi: 10.1016/j.cmi.2021.09.017
Web of Science
PubMed
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FullText_MUG
- Führende Autor*innen der Med Uni Graz
- Leitner-Meyer Eva
- Co-Autor*innen der Med Uni Graz
- Bozic Michael
- Hoegenauer Christoph
- Kessler Harald
- Kienesberger-Feist Sabine
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- Abstract:
- OBJECTIVE: Toxin-producing Klebsiella oxytoca causes antibiotic-associated haemorrhagic colitis (AAHC). The disease-relevant cytotoxins tilivalline and tilimycine produced by certain K. oxytoca isolates are encoded by the non-ribosomal peptide synthetase genes A (npsA) and B (npsB). In this study, the new LightMix® Modular kit for the detection of relevant K. oxytoca sensu lato (s.l.) toxin genes was evaluated. METHODS: DNA was extracted on the automated EMAG® platform. Amplification was done on the Light Cycler® 480 II instrument. In total, 130 residual faecal specimens collected from patients with antibiotic-associated diarrhoea were studied to determine the clinical sensitivity and specificity. Toxigenic culture served as reference method. RESULTS: With the new kit, the limit of detection was 15 CFU/mL for all targets. For the pehX target specific to K. oxytoca s.l., 65 of 130 clinical specimens were positive, while toxin-specific targets (npsA/npsB) were positive in 47 of 130. The npsA/npsB PCR targets showed a clinical sensitivity of 100% (95%CI 80.5-100%) and a specificity of 73.5% (95%CI 64.3-81.3%) with a positive predictive value of 16.5% (95%CI 12.7-21.2%) and a negative predictive value of 100%. CONCLUSION: Compared with culture, additional clinical specimens positive for K. oxytoca s.l. were detected with real-time PCR. The specificity of the toxin targets appears moderate due to the inferior sensitivity of the culture-based reference method. Since the developed assay is highly sensitive, it may be used as first-line method to improve the diagnosis of AAHC.
- Find related publications in this database (using NLM MeSH Indexing)
- Anti-Bacterial Agents - therapeutic use
- Colitis - complications, diagnosis, drug therapy
- Enterocolitis, Pseudomembranous - drug therapy
- Hemorrhage - administration & dosage
- Humans - administration & dosage
- Klebsiella Infections - microbiology
- Klebsiella oxytoca - genetics
- Real-Time Polymerase Chain Reaction - administration & dosage
- Find related publications in this database (Keywords)
- AAD
- Diagnosis
- Klebsiella oxytoca
- Real-time PCR
- Toxin genes