title: Comparison of cycloserine-cefoxitin-fructose agar (CCFA) and taurocholate-CCFA for recovery of Clostridium difficile during surveillance of hospitalized patients.
abstract: The effectiveness of cycloserine-cefoxitin-fructose agar (CCFA) and taurocholate-CCFA (TCCFA) in isolating Clostridium difficile from swabs of the rectum or stools from 184 hospitalized patients who were monitored weekly and when they had diarrhea was compared. The number of surveillance time points ranged from two to eight per patient over a period of 4 to 34 days per patient, totalling 621 comparisons of the media. C. difficile was isolated more frequently by TCCFA than CCFA at seven of eight surveillance points, a significant trend (O'Brien test, p = 0.002). This difference reached statistical significance at the second surveillance time point when the prevalence of C. difficile was sufficiently high. At the second surveillance point, C. difficle was isolated only by TCCFA in 7 of 184 comparisons of the media, only by CCFA in none of the comparisons, and by both media in 19 comparisons (p = 0.016). C. difficle was first isolated at an earlier surveillance time point on TCCFA in 11 of 36 patients and on CCFA first only once (p = 0.005). Use of TCCFA media increased the rapidity and sensitivity of culture for C. difficle when doing patient surveillance but did not increase sensitivity when diagnosing patients with diarrhea.
authors.affiliation: School of Nursing, University of Minnesota, Minneapolis 55455-0324, USA.
authors.forename: D Z
authors.initials: DZ
authors.lastname: Bliss
authors.forename: S
authors.initials: S
authors.lastname: Johnson
authors.forename: C R
authors.initials: CR
authors.lastname: Clabots
authors.forename: K
authors.initials: K
authors.lastname: Savik
authors.forename: D N
authors.initials: DN
authors.lastname: Gerding
mesh_terms: D000904:Antibiotics, Antitubercular / Q000494:pharmacology; D002440:Cefoxitin; D002513:Cephamycins / Q000494:pharmacology; D002756:Cholagogues and Choleretics / Q000494:pharmacology; D016360:Clostridioides difficile / Q000254:growth & development / Q000302:isolation & purification*; D003428:Cross Infection / Q000382:microbiology*; D003470:Culture Media / Q000737:chemistry*; D003523:Cycloserine; D003967:Diarrhea / Q000382:microbiology*; D005243:Feces / Q000382:microbiology; D005632:Fructose; D006801:Humans; D011446:Prospective Studies; D012007:Rectum / Q000382:microbiology; D054047:Surgical Stomas / Q000382:microbiology; D013656:Taurocholic Acid
chemical_list: D000904:Antibiotics, Antitubercular; D002513:Cephamycins; D002756:Cholagogues and Choleretics; D003470:Culture Media; D005632:Fructose; D013656:Taurocholic Acid; D002440:Cefoxitin; D003523:Cycloserine