title: Diagnosis of Clostridium difficile antibiotic associated diarrhoea culture versus toxin assay.
abstract: OBJECTIVE
  To compare the results of Clostridium Difficile (CD) on culture with detection of C. difficile toxin by Enzyme Immunoassay (EIA) in the stool specimens of hospitalized patients with antibiotic associated diarrhoea (AAD).
  
  
  METHODS
  The study included 80 adult patients with AAD and 20 adult patients with non-AAD. Stool specimens of all these subjects were inoculated on cycloserine cefoxitin fructose agar and incubated anaerobically to isolate C. difficile. At the same time, all the stool specimens were tested for C. difficile toxin by EIA technique using cytoclone A and B kit manufactured by Cambridge Biotech Corporation, Worcester, Massachusette.
  
  
  RESULTS
  Out of 80 adult patients with AAD, thirty were females and fifty males. C. difficile was isolated on culture from stool specimen of 16 patients, while twenty-three stool specimens were positive for C. difficile toxin. From 20 control subjects, C. difficile was isolated from stool specimen of only one subject. No stool specimen from the controls was positive for toxin.
  
  
  CONCLUSIONS
  Diagnosis of CDAAD by culture is difficult and time consuming because of strict anaerobic nature of organism. Moreover, mere isolation of C. difficile on culture is not sufficient to establish the pathogenic role of these isolates. C. difficile toxin detection by EIA technique is a highly sensitive and specific method for diagnosis of CDAAD. Using this method, results are available in three hours time. Therefore, EIA is recommended for rapid diagnosis of CDAAD.
authors.affiliation: Department of Pathology, Postgraduate Medical Institute, Lahore.
authors.forename: Q
authors.initials: Q
authors.lastname: Sultana
authors.forename: N A
authors.initials: NA
authors.lastname: Chaudhry
authors.forename: M
authors.initials: M
authors.lastname: Munir
authors.forename: M S
authors.initials: MS
authors.lastname: Anwar
authors.forename: M
authors.initials: M
authors.lastname: Tayyab
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000900:Anti-Bacterial Agents / Q000009:adverse effects; D003015:Clostridium Infections / Q000139:chemically induced / Q000175:diagnosis*; D046508:Culture Techniques; D003967:Diarrhea / Q000175:diagnosis / Q000382:microbiology*; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged
chemical_list: D000900:Anti-Bacterial Agents