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Contrasting Results from Two Commercial Kits Testing for the Presence of Clostridium perfringens Enterotoxin in Feces from Norovirus-Infected Human Patients by Taisei Ishioka, Yoshiyuki Aihara, Yuki Carle, Hiroaki Shigemura, Akiko Kubomura, Takumi Motoya, Arimi Nakamoto, Asako Nakamura, Shuji Fujimoto, Shinichiro Hirai, Kazunori Oishi, Hiromi Nagaoka, Hirokazu Kimura, Koichi Murakami

Background: Detection of Clostridium perfringens enterotoxin (CPE) is critical for disease surveillance; however, commercial testing kits produce contrasting results.
Methods: We examined the cause of the differing results from a reversed passive latex agglutination (RPLA) assay (PET-RPLA Toxin Detection Kit) and an enzyme-linked immunosorbent assay (C. perfringens Enterotoxin ELISA Kit) using 73 human norovirus-positive fecal samples from gastroenteritis patients across 22 episodes in Japan.
Results: CPE was detected in 39/73 samples using the RPLA method; however, ELISA-based examination of 10 RPLA-positive samples produced negative results. Moreover, cpe was not detected in any of the RPLA-positive (n = 32) or -negative (n = 5) samples, and C. perfringens was only isolated from one RPLA-positive sample.
Conclusions: An ELISA-based testing approach may be more reliable than RPLA assays for CPE detection from human fecal samples. These findings may also be applicable to the detection of other foodborne diseases.

DOI: 10.7754/Clin.Lab.2019.190801