Clostridium difficile and its cytotoxin in feces of patients with antimicrobial agent-associated diarrhea and miscellaneous conditions.
Fecal specimens from 223 subjects were evaluated for the presence of Clostridium difficile by use of a selective medium developed in our laboratory and for the presence of C. difficile cytotoxin. C. difficile and cytotoxin were detected in 89 and 83%, respectively, of patients with antimicrobial agent-associated pseudomembranous colitis (PMC). In patients in whom PMC was not documented, C. difficile and cytotoxin were present in only 37 and 21%, respectively. C. difficile and cytotoxin were also recovered from the feces of 6 and 3, respectively, of 13 antimicrobial recipients who did not have diarrhea. Although C. difficile appears to be a major cause of PMC, it is not responsible for at least some two-thirds of cases of antimicrobial agent-associated diarrhea in which PMC is not documented. Neither the recovery of C. difficile nor the detection of its cytotoxin should be considered diagnostic for C. difficile-induced disease.
D000900:Anti-Bacterial Agents / Q000009:adverse effects*; D001427:Bacterial Toxins / Q000032:analysis*; D003013:Clostridium / Q000302:isolation & purification*; D003603:Cytotoxins / Q000032:analysis; D003967:Diarrhea / Q000209:etiology / Q000382:microbiology*; D004761:Enterocolitis, Pseudomembranous / Q000209:etiology / Q000382:microbiology; D005243:Feces / Q000032:analysis / Q000382:microbiology*; D006801:Humans
D000900:Anti-Bacterial Agents; D001427:Bacterial Toxins; D003603:Cytotoxins