title: Effective and reduced-cost modified selective medium for isolation of Clostridium difficile.
abstract: Both for epidemiologic studies and for diagnostic testing, there is a need for effective, economical, and readily available selective media for the culture of Clostridium difficile. We have developed a reduced-cost substitute for cycloserine-cefoxitin-fructose agar (CCFA), which is an effective but expensive selective medium for C. difficile. The modified medium, called C. difficile brucella agar (CDBA), includes an enriched brucella base as a substitute for proteose peptone no. 2, and the concentration of sodium taurocholate has been reduced from 0.1% to 0.05%. To compare the sensitivities and selectivities of CDBA and CCFA, cultures for C. difficile were performed using stool samples from patients with C. difficile-associated disease. CDBA was as sensitive as CCFA for the recovery of C. difficile, with a similar frequency of breakthrough growth of stool microflora (25% versus 31%, respectively). A liquid formulation of the modified medium, termed C. difficile brucella broth (CDBB), stimulated rapid germination and outgrowth of C. difficile spores, at a rate comparable to that in cycloserine-cefoxitin-fructose broth. Our results suggest that CDBA and CDBB are sensitive, selective, and reduced-cost media for the recovery of C. difficile from stool samples.
authors.affiliation: Research Service, Louis Stokes Cleveland Veterans Affairs Medical Center, Cleveland, Ohio 44106, USA.
authors.forename: Michelle M
authors.initials: MM
authors.lastname: Nerandzic
authors.forename: Curtis J
authors.initials: CJ
authors.lastname: Donskey
mesh_terms: D001431:Bacteriological Techniques / Q000191:economics* / Q000379:methods*; D016360:Clostridioides difficile / Q000302:isolation & purification*; D003470:Culture Media / Q000737:chemistry* / Q000191:economics*; D004760:Enterocolitis / Q000382:microbiology; D006801:Humans; D012680:Sensitivity and Specificity
chemical_list: D003470:Culture Media