Korean J Clin Microbiol.  2002 Sep;5(2):124-128.

Evaluation of Quantitative culture of Clostridium difficile From Fecal Specimens for the Diagnosis of C. difficile-associated Disease

• Yong D
• Lee HM
• Ryu JH
• Roh KH
• Kim WH
• Lee K
• Chong Y

Abstract

BACKGROUND: C. difficile-associated diarrhea (CDAD), the most frequently identified cause of nosocomial diarrhea, results from the overgrowth of cytotoxin (toxin B)-producing strains. The aim of this study was to evaluate the quantitative culture of Clostridium difficile to improve the laboratory diagnosis of CDAD.
METHODS
The quantitative culture and cytotoxin gene results were evaluated based on the findings of colonoscopy and/or histology of the biopsy specimens.
RESULTS
Among the 402 specimens with cytotoxin-positive isolates, 301 (74.9%) contained > or =106 CFU/mL of C. difficile. Nine (60%) of the 15 pseudomembranous colitis patients yielded > or =106 CFU/mL of toxigenic isolate. The proportion of cytotoxin gene-positive isolates was higher in the specimens with > or =106 CFU/mL of C. difficile than in those with 102-<103 CFU/mL (86.5% vs. 66.7%).
CONCLUSIONS
Quantitative culture may aid in the interpretation of toxigenic C. difficile culture results, and reduce false positivity, thus avoiding unnecessary treatment.

Keyword

Clostridium difficile; C. difficile-associated diarrhea; pseudomembranous colitis; quantitative culture; cytotoxin

MeSH Terms

Biopsy
Clinical Laboratory Techniques
Clostridium difficile*
Clostridium*
Colonoscopy
Diagnosis*
Diarrhea
Enterocolitis, Pseudomembranous
Humans