What is the sensitivity and specificity of the Campylobacter antigen Enzyme Immunoassay (EIA) for stool?

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DS

Dainyal Siddiqui, MD

Internal Medicine

MJ

Manuel Jimenez, MD

Cardiology

FP

Franz Pierre-Louis, MD

Infectious Disease

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Last updated: April 8, 2025 • View editorial policy

From the Guidelines

The campylobacter antigen EIA for stool has a sensitivity of 80-90% and specificity of 95-98%, as reported in the most recent clinical evaluations 1. This means the test correctly identifies about 80-90% of true Campylobacter infections and correctly rules out the infection in 95-98% of uninfected individuals. The test detects specific antigens from Campylobacter species in stool samples, primarily C. jejuni and C. coli which cause most human infections. Some key points to consider when interpreting the results of the campylobacter antigen EIA include:

  • Performance may vary depending on the specific commercial kit used, the timing of specimen collection relative to symptom onset, and prior antibiotic use.
  • The test is most sensitive when performed on fresh stool samples collected during the acute phase of illness (within the first 4-5 days of symptoms).
  • False negatives can occur if the sample is collected late in the course of illness when bacterial shedding has decreased or after antibiotic treatment has begun. While culture remains the gold standard for diagnosis, the EIA offers advantages of rapid turnaround time (results available in hours versus days for culture) and ease of performance, making it useful in settings where quick results are needed to guide management decisions for patients with acute diarrheal illness, as recommended by the 2017 Infectious Diseases Society of America clinical practice guidelines for the diagnosis and management of infectious diarrhea 1.

From the Research

Campylobacter Antigen EIA Sensitivity and Specificity

  • The sensitivity and specificity of the Premier CAMPY EIA were 99.3% and 98%, respectively, as reported in a study comparing conventional culture with three EIA methods for the detection of C. jejuni and C. coli in 485 patient stool samples 2.
  • Another study evaluating the performance of stool antigen CIDTs compared to culture and PCR for Campylobacter detection found that the stool antigen CIDTs ranged from 79.6% to 87.6% in sensitivity and 95.9 to 99.5% in specificity 3.
  • A study comparing culture, EIA, and PCR for the detection of Campylobacter in stool samples from infants in developing countries found that the sensitivity and specificity of the ProSpecT EIA were not explicitly stated, but the EIA-positive samples were mostly positive by PCR for C. jejuni/C. coli 4.
  • A study on the rapid detection of Campylobacter antigen by enzyme immunoassay found that the positive predictive value (PPV) of the EIA was 91% when compared to culture, but fell to 42% during routine diagnostic testing 5.
  • An evaluation of an enzyme immunoassay-based stool antigen test to detect Campylobacter jejuni and Campylobacter coli found that the sensitivity and specificity of the test were 69% and 87%, respectively, when compared to culture 6.

Variability in Sensitivity and Specificity

  • The sensitivity and specificity of Campylobacter antigen EIAs vary across different studies, with sensitivity ranging from 69% to 99.3% and specificity ranging from 87% to 99.5% 2, 3, 6.
  • The variability in sensitivity and specificity may be due to differences in the EIA methods used, the population being tested, and the reference standards used for comparison 2, 3, 4, 5, 6.

References

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Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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