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Detection of Clostridium difficile Infection

  • John G. Bartlett (a1)


There has been a recent surge of interest in Clostridium difficile infection, which reflects an impressive increase in the number and severity of these infections. This review addresses some of the newer methods for detection of C. difficile infection at the bedside and in the laboratory. Particularly important are the new rapid diagnostic tests that detect toxigenic C. difficile using polymerase chain reaction and the combination tests that, either simultaneously or sequentially, screen for C. difficile and test for toxins A and B. It is expected that these new testing methods will largely supplant the enzyme immunoassays for toxins, which are used by most laboratories, departments, and divisions. The present goal is to combine clinical, laboratory, and animal research related to C. difficile that reflects issues that are considered to be major contemporary challenges. Among this work is the pursuit of studies of immune mechanisms to better control this disease.


Corresponding author

Johns Hopkins University, School of Medicine, 1830 East Monument Street, Room 447, Baltimore, MD 21205 (


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1.O'Connor, JR, Johnson, S, Gerding, DN. Clostridium difficile infection caused by the epidemic BI/NAP1/027 strain. Gastroenterology 2009;136(6):19131924.
2.Bryant, K, McDonald, LC. Clostridium difficile infections in children. Pediatr Infect Dis J 2009;28(2):145146.
3.McDonald, LC, Killgore, GE, Thompson, A, et al.An epidemic, toxin gene-variant strain of Clostridium difficile. N Engl J Med 2005;353(23):24332441.
4.Centers for Disease Control and Prevention. Surveillance for community-associated Clostridium difficile—Connecticut, 2006. MMWR Morb Mortal Wkly Rep 2008;57(13):340343.
5.Rouphael, NG, O'Donnell, JA, Ghatnagar, J, Lewis, F, Polgreen, PM. Clostridium difficile-associated diarrhea: an emerging threat to pregnant women. Am J Obstet Gynecol 2008;198(6):685.e1685.e6.
6.Lamontagne, F, Labbe, AC, Haeck, O, et al.Impact of emergency colectomy on survival of patients with fulminant Clostridium difficile colitis during an epidemic caused by a hypervirulent strain. Ann Surg 2007;245(2):267272.
7.Crobach, MJ, Dekkers, OM, Wilcox, MH, et al.European Society of Clinical Microbiology and Infectious Diseases (ESCMID): data review and recommendations for diagnosing Clostridium difficile-infection (CDI). Clin Microbiol Infect 2009;15(12):10531066.
8.Quinn, CD, Sefers, SE, Babiker, W, et al.C. Diff Quik Chek complete enzyme immunoassay provides a reliable first-line method for detection of Clostridium difficile in stool specimens. J Clin Microbiol 2010;48(2):603605.
9.Peterson, LR, Robicsek, A. Does my patient have Clostridium difficile infection? Ann Intern Med 2009;151(3):176179.
10.McFarland, LV, Mulligan, ME, Kwok, RY, Stamm, WE. Nosocomial acquisition of Clostridium difficile infection. N Engl J Med 1989;320(4):204210.
11.Mohan, SS, McDermott, BP, Parchuri, S, Cunha, BA. Lack of value of repeat stool testing for Clostridium difficile toxin. Am J Med 2006;119(4):356.e7356.e8.
12.Cohen, SH, Gerding, DN, Johnson, S, et al.Clinical practice guidelines for Clostridium difficile infection in adults: 2010 update by the Society for Healthcare Epidemiology of America (SHEA) and the Infectious Diseases Society of America (IDSA). Infect Control Hosp Epidemiol 2010;31(5):431455.
13.Bouadma, L, Lyut, CE, Tubach, F, et al.Use of procalcitonin to reduce patients' exposure to antibiotics in intensive care units (PRORATA trial): a multicentre randomized controlled trial. Lancet 2010;375(9713):463474.
14.Lowy, I, Molrine, DC, Leav, BA, et al.Treatment with monoclonal anti-bodies against Clostridium difficile toxins. N Engl J Med 2010;362(3):197205.


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