Abstract
Several procedures have been described for the culture of Clostridium difficile from stool specimens. The goal of this study was to determine the effectiveness of five of these methods for the isolation of C. difficile from feces of patients suspected of having C. difficile-associated illness. A total of 564 stool specimens were cultured by using heat shock, ethanol treatment (ET), and direct plating on Carr-Scarborough cycloserine-cefoxitin-fructose agar (CCFA) with horse blood (C/S medium), BBL CCFA medium, and Remel C. difficile agar. Cytotoxin assays were performed on all specimens. A total of 113 specimens (20%) were positive for C. difficile by one or more methods. The numbers of positive cultures by using heat shock, ET, and direct plating on C/S medium, BBL CCFA medium, and Remel C. difficile agar were 79 (70%), 89 (79%), 91 (81%), 79 (70%), and 52 (46%), respectively. We concluded that ET and direct plating on C/S medium were the most effective procedures for isolating C. difficile from stool specimens and found significant variation in the performance of modified CCFA from different manufacturers.
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Selected References
These references are in PubMed. This may not be the complete list of references from this article.
- Bartlett J. G., Chang T. W., Gurwith M., Gorbach S. L., Onderdonk A. B. Antibiotic-associated pseudomembranous colitis due to toxin-producing clostridia. N Engl J Med. 1978 Mar 9;298(10):531–534. doi: 10.1056/NEJM197803092981003. [DOI] [PubMed] [Google Scholar]
- Bartlett J. G. Clostridium difficile: clinical considerations. Rev Infect Dis. 1990 Jan-Feb;12 (Suppl 2):S243–S251. doi: 10.1093/clinids/12.supplement_2.s243. [DOI] [PubMed] [Google Scholar]
- Bennett R. G., Laughon B. E., Mundy L. M., Bobo L. D., Gaydos C. A., Greenough W. B., 3rd, Bartlett J. G. Evaluation of a latex agglutination test for Clostridium difficile in two nursing home outbreaks. J Clin Microbiol. 1989 May;27(5):889–893. doi: 10.1128/jcm.27.5.889-893.1989. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Bowman R. A., Riley T. V. Laboratory diagnosis of Clostridium difficile-associated diarrhoea. Eur J Clin Microbiol Infect Dis. 1988 Aug;7(4):476–484. doi: 10.1007/BF01962596. [DOI] [PubMed] [Google Scholar]
- Clabots C. R., Gerding S. J., Olson M. M., Peterson L. R., Gerding D. N. Detection of asymptomatic Clostridium difficile carriage by an alcohol shock procedure. J Clin Microbiol. 1989 Oct;27(10):2386–2387. doi: 10.1128/jcm.27.10.2386-2387.1989. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Dzink J., Bartlett J. G. In vitro susceptibility of Clostridium difficile isolates from patients with antibiotic-associated diarrhea or colitis. Antimicrob Agents Chemother. 1980 Apr;17(4):695–698. doi: 10.1128/aac.17.4.695. [DOI] [PMC free article] [PubMed] [Google Scholar]
- George W. L., Sutter V. L., Citron D., Finegold S. M. Selective and differential medium for isolation of Clostridium difficile. J Clin Microbiol. 1979 Feb;9(2):214–219. doi: 10.1128/jcm.9.2.214-219.1979. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Iwen P. C., Booth S. J., Woods G. L. Comparison of media for screening of diarrheic stools for the recovery of Clostridium difficile. J Clin Microbiol. 1989 Sep;27(9):2105–2106. doi: 10.1128/jcm.27.9.2105-2106.1989. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Kamiya S., Yamakawa K., Ogura H., Nakamura S. Recovery of spores of Clostridium difficile altered by heat or alkali. J Med Microbiol. 1989 Mar;28(3):217–221. doi: 10.1099/00222615-28-3-217. [DOI] [PubMed] [Google Scholar]
- Koransky J. R., Allen S. D., Dowell V. R., Jr Use of ethanol for selective isolation of sporeforming microorganisms. Appl Environ Microbiol. 1978 Apr;35(4):762–765. doi: 10.1128/aem.35.4.762-765.1978. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Lashner B. A., Todorczuk J., Sahm D. F., Hanauer S. B. Clostridium difficile culture-positive toxin-negative diarrhea. Am J Gastroenterol. 1986 Oct;81(10):940–943. [PubMed] [Google Scholar]
- Wu T. C., Gersch S. M. Evaluation of a commercial kit for the routine detection of Clostridium difficile cytotoxin by tissue culture. J Clin Microbiol. 1986 Apr;23(4):792–793. doi: 10.1128/jcm.23.4.792-793.1986. [DOI] [PMC free article] [PubMed] [Google Scholar]