Table 2.

Stool Tests for Clostridioides difficile Infection

Test	Detects	Advantages	Disadvantages
Cell culture cytotoxicity neutralization assay	Primarily toxin B but also toxin A to some extent	Highly sensitive and specific	Requires tissue culture facility
Toxin enzyme immunoassay	Toxin A and B	Fast (2–6 h), easy to perform, highly specific	Not as sensitive as other assays
Glutamate dehydrogenase enzyme immunoassay	Bacterial enzyme (glutamate dehydrogenase)found in toxigenic and nontoxigenic C difficile	Fast, inexpensive, easy to perform, highly sensitive	Low specificity for toxin-producing C difficile-related disease
Toxigenic culture	Toxigenic C difficile	Highly sensitive; allows strain typing in epidemics	Requires anaerobic culture; takes 2–5 d; low specificity for predicting C difficile-related disease
Nucleic acid amplification test	C difficile toxin genes	Highly sensitive	Low specificity for predicting C difficile-related disease