目的比较不同方法检测艰难梭菌(CD)的临床可行性。方法选取2016年疑似抗菌药物相关腹泻患者大便标本,采用酶联免疫吸附试验(ELISA)和鉴定培养基培养法进行检测,比较两种检测方法的灵敏性、特异性和一致性。结果 ELISA检出抗原阳性标本29例,其中毒素阳性25例,毒素阴性4例;鉴定培养基培养法检出可疑菌株29例,经质谱仪鉴定,其结果为CD28例,1例未检出种属;ELISA和鉴定培养基培养法的灵敏度和特异度分别为97%、100%和93%、95%,两者有极好的一致性(Kappa=0.92)。结论 ELISA具有快速、高效、省时、操作简单、判读容易等特点,可快速准确地筛检CD相关性腹泻病患;培养基培养法特异性好,可以快速得到感染株;二者联合使用可大大提高CD检出率,并对后期治疗有很大帮助。 Objective To compare the clinical feasibility of detecting C. difficile (CD) by different methods. Methods Totally stool specimens from patients with suspected antibiotic-associated diarrhea in 2016 were selected and tested by enzyme-linked immunosorbent assay (ELISA) and culture medium identification. The sensitivity, specificity and consistency of the two methods were compared. Results Twenty - nine antigen positive samples were detected by ELISA. Among them, 25 were positive for toxin and 4 were negative for toxin. Twenty - nine suspicious strains were identified by culture medium assay and identified by mass spectrometry. The results were CD28 cases and one case was undetected The sensitivity and specificity of ELISA and identification culture medium were 97%, 100% and 93%, 95%, respectively, with excellent agreement (Kappa = 0.92). Conclusion ELISA is rapid, efficient, time-saving, easy to operate, easy to read and so on, which can screen CD related diarrhea patients quickly and accurately. The medium culture method has good specificity and can get infected strains rapidly. Greatly improve the detection rate of CD, and the late treatment is very helpful.