Campylobacter culture fails to correctly detect Campylobacter in 30%of positive patient stool specimens compared to non-cultural methods

AbstractCampylobacter diagnosis is hampered because many laboratories continue to use traditional stool culture, which is slow andsuffers false-negative results. This large multi-site study used a composite reference method consisting of a new FDA-clearedimmunoassay and four molecular techniques to compare to culture. Prospectively collected patient fecal specimens (1552) werefirst preliminarily categorized as positive or negative by traditional culture. All specimens were also tested by EIA, and any EIApositiveor culture-discrepant results were further characterized by 16S rRNA qPCR, eight species-specific PCR assays, bidirectionalsequencing, and an FDA-cleared multiplex PCR panel. The five non-culture methods showed complete agreement onall positive and discrepant specimens which were then assigned as true-positive or true-negative specimens. Among 47 truepositivespecimens, culture incorrectly identified 13 (28%) as negative, and 1 true-negative specimen as positive, for a sensitivityof 72.3%. Unexpectedly, among the true-positive specimens, 4 (8%) were the pathogenic species C. upsaliensis. Culture had a30% false result rate compared to immunoassay and molecular methods. More accurate results lead to better diagnosis andtreatment of suspected campylobacteriosis.Keywords Campylobacter spp. . Culture . Immunoassay . Campylobacter upsaliensis . Composite reference metho