Immunological testing for occult blood in patients with acute infectious diarrhea: Can it improve the specificity of the guaiac test?

Microscopic stool examination can distinguish inflammatory from noninflammatory diarrheas. The modified guaiac test was shown to have good correlation to stool microscopy. In a prospective study we evaluated the diagnostic accuracy of a modified guaiac test (Colo-Rectal-Test, Roche) and of an immuno...

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Bibliographic Details
Published in:Digestive diseases and sciences 1997-02, Vol.42 (2), p.366-371
Main Authors: BELTINGER, J, WALTHER, R, BARDHAN, P, MAHALANABIS, D, GYR, K
Format: Article
Language:English
Subjects:
Acute Disease
Adolescent
Bacteria - isolation & purification
Bacterial diseases
Bacterial diseases of the digestive system and abdomen
Bacterial Infections - complications
Bacterial Infections - diagnosis
Bacterial Infections - microbiology
Bacterial Infections - pathology
Biological and medical sciences
Child
Child, Preschool
Diarrhea - diagnosis
Diarrhea - etiology
Diarrhea - microbiology
Diarrhea - pathology
Feces - microbiology
Female
Guaiac
Hemoglobins - analysis
Human bacterial diseases
Humans
Indicators and Reagents
Infant
Infectious diseases
Inflammation
Latex Fixation Tests
Male
Medical sciences
Occult Blood
Predictive Value of Tests
Prospective Studies
Sensitivity and Specificity
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Summary:Microscopic stool examination can distinguish inflammatory from noninflammatory diarrheas. The modified guaiac test was shown to have good correlation to stool microscopy. In a prospective study we evaluated the diagnostic accuracy of a modified guaiac test (Colo-Rectal-Test, Roche) and of an immunological test for fecal haemoglobin (Colo-Immun-Test, Roche) in relation to the diarrheal pathogens identified and compared it with the stool microscopy. In 304 patients, clinical presentation, stool microscopy, stool culture, and modified guaiac test were recorded. Sensitivity of the guaiac test was 69% as compared to 63-67% for the stool microscopy. Specificity could be improved by 10-15% using an immunological test to exclude false-positive guaiac reactions. A modified guaiac test can replace microscopic stool examination to distinguish between inflammatory and non-inflammatory diarrhea. Immunological testing for occult blood can improve the specificity of the guaiac test, but is too elaborate to serve as a screening test. The modified guaiac test can easily be handled by community health workers and could be important in the diagnostic work-up for acute infectious diarrhea.
ISSN:0163-2116
1573-2568
DOI:10.1023/A:1018878221658