Comparison of norovirus incidence with ELİSA and molecular methods inclostridium difficile positive patients

Objective: The aim of this study is to detect the presence of norovirus in Clostridium difficile toxin positive patients with two different methods, ELISA and Molecular methods. Material and methods: Between January 2019 and March 2020, 82 patient samples found positive with the Rapid Diagnostic Kit of Clostridium difficile toxin (CerTest, GDH + Toxin A + B (BIOTEC, Spain)) were included. In these examples, norovirus was investigated by two methods. The first stage of the study was to search for norovirus antigen by ELISA (RIDASCREEN Norovirus kit (R-Biopharm, Darmstadt, Germany)). In the second stage, nucleic acid was searched in the same samples using the real-time RT-PCR method (Corbett Rotor-Gene 6000 HRM). Results: Norovirus positivity was found as 3,7% (n: 3) by ELISA in a total of 82 samples included in the study. Norovirus positivity in real-time RT-PCR of the same samples was evaluated as 8,5% (n: 7). When the RT-PCR is taken as reference, the sensitivity of the ELISA test was 63,6% and the specificity was 100%. Conclusion: In our study, co-infection with norovirus was observed with a rate of 8,5% in C. difficile toxin positive patients, and this rate is consistent with the literature. Clinicians should consider possible norovirus infection, especially for C.difficile toxin positive patients with immunodeficiency. It is important to consider interactions between enteropathogens, to search for different diagnoses and to direct treatment accordingly in patients with long-lasting diarrhea.