Question Time — Scottish Executive — Health and Wellbeing – in the Scottish Parliament at 2:15 pm on 11 February 2010.
To ask the Scottish Executive what discussions it has had with regard to changes in testing for health care associated infections. (S3O-9492)
Discussions take place between Scottish Government officials, Health Protection Scotland, the Scottish microbiology forum and the Scottish national clostridium difficile reference laboratory on an on-going basis to ensure that testing for C diff infection reflects best practice and conforms to European recommendations. The chief nursing officer issued new guidance last month on testing for C diff for implementation by all microbiology labs across Scotland.
On 25 November, following the outbreak in Dundee, I asked about the rapid polymerase chain reaction test that was being used in Dundee for pathogenic C difficile. I am pleased that the new algorithm on C difficile testing now includes PCR. Does the cabinet secretary agree that the standard ELISA test that has previously been used as a screening test is no longer fit for purpose? Can she tell me whether the ELISA test is still the initial screening test for the new algorithm, which is a two-stage test? If that is the case, will she publish the detail of how and why the experts are still of the view that two-stage testing is required, rather than PCR testing alone,
The ELISA test, as Richard Simpson will know but other members may not, is a biochemical technique used mainly in immunology to detect the presence of an antibody in a sample. As I said, the chief nursing officer issued new guidance last month on the testing for C diff for implementation by all labs. The consensus behind that guidance follows the evaluation report " Clostridium difficile toxin detection assays", which was published in February last year by the NHS Purchasing and Supply Agency. It recognises the shortcomings in current testing methods and recommends a two-step testing algorithm for provisional positives. NHS Scotland has advised the use of testing kits as recommended by the agency in its 2009 report. I am more than happy to enter into more detailed correspondence with Richard Simpson on some of the more technical details of the issue.