Ann Lab Med.  2014 Sep;34(5):376-379. 10.3343/alm.2014.34.5.376.

Performance of chromID Clostridium difficile Agar Compared with BBL C. difficile Selective Agar for Detection of C. difficile in Stool Specimens

  • 1Department of Laboratory Medicine, Yeouido St. Mary's Hospital, Seoul, Korea.
  • 2Department of Laboratory Medicine, Seoul St. Mary's Hospital, Seoul, Korea.
  • 3Department of Biostatistics, College of Medicine, The Catholic University of Korea, Seoul, Korea.


We evaluated the performance of a new chromogenic medium for detection of Clostridium difficile, chromID C. difficile agar (CDIF; bioMerieux, France), by comparison with BBL C. difficile Selective Agar (CDSA; Becton Dickinson and Company, USA). After heat pre-treatment (80degrees C, 5 min), 185 diarrheal stool samples were inoculated onto the two media types and incubated anaerobically for 24 hr and 48 hr for CDIF and for 48 hr and 72 hr for CDSA. All typical colonies on each medium were examined by Gram staining, and the gram-positive rods confirmed to contain the tpi gene by PCR were identified as C. difficile. C. difficile was recovered from 36 samples by using a combination of the two media. The sensitivity with CDIF 48 hr was highest (100%) and was significantly higher than that with CDIF 24 hr (58.3%; P<0.001), because samples with a low burden of C. difficile tended to require prolonged incubation up to 48 hr (P<0.001). The specificity of CDIF 24 hr and CDIF 48 hr (99.3% and 90.6%, respectively) was significantly higher than that of CDSA 48 hr and CDSA 72 hr (72.5% and 67.1%, respectively; P<0.001). CDIF was effective for detecting C. difficile in heat-pretreated stool specimens, thus reducing unnecessary testing for toxin production in non-C. difficile isolates and turnaround time.


Clostridium difficile; Chromogenic agar; Performance; ChromID C. difficile agar; Toxigenic culture

MeSH Terms

Bacterial Proteins/genetics
Bacteriological Techniques/*methods
Chromogenic Compounds/chemistry/metabolism
Clostridium difficile/genetics/*isolation & purification
Culture Media/chemistry
DNA, Bacterial/analysis/metabolism
Polymerase Chain Reaction
Time Factors
Bacterial Proteins
Chromogenic Compounds
Culture Media
DNA, Bacterial
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