title: Improved recovery of Clostridium difficile spores with the incorporation of synthetic taurocholate in cycloserine-cefoxitin-fructose agar (CCFA).
abstract: OBJECTIVE
  Culture remains important for the detection and typing of Clostridium difficile. Culture of C. difficile spores can be enhanced on media supplemented with a germinant. Despite this, unsupplemented media continues to be used in some laboratories. The aim of this study was to quantify the effect of the known germinant sodium taurocholate on recovery of C. difficile spores and to determine if the supplement impacts on the recovery of vegetative C. difficile.
  
  
  METHODS
  The recovery on cycloserine-cefoxitin-fructose agar (CCFA) with and without taurocholate, of spore, vegetative, and total cell fractions of broth cultures of eight C. difficile isolates was compared.
  
  
  RESULTS
  Taurocholate in CCFA did not inhibit growth of vegetative C. difficile and significantly increased recovery of spores (p = 0.04).
  
  
  CONCLUSIONS
  The routine incorporation of taurocholate in CCFA is recommended for improved sensitivity in C. difficile culture from specimens.
authors.affiliation: School of Pathology and Laboratory Medicine, The University of Western Australia, Queen Elizabeth II Medical Centre, Nedlands, Australia. niki.foster@uwa.edu.au
authors.forename: Niki Francis
authors.initials: NF
authors.lastname: Foster
authors.forename: Thomas Victor
authors.initials: TV
authors.lastname: Riley
mesh_terms: D000362:Agar; D002513:Cephamycins / Q000494:pharmacology; D002756:Cholagogues and Choleretics / Q000494:pharmacology*; D016360:Clostridioides difficile / Q000254:growth & development / Q000302:isolation & purification*; D003015:Clostridium Infections / Q000175:diagnosis* / Q000382:microbiology; D003470:Culture Media / Q000737:chemistry*; D003523:Cycloserine / Q000494:pharmacology; D005632:Fructose / Q000494:pharmacology; D006801:Humans; D013171:Spores, Bacterial / Q000302:isolation & purification; D013656:Taurocholic Acid / Q000494:pharmacology*
chemical_list: D002513:Cephamycins; D002756:Cholagogues and Choleretics; D003470:Culture Media; D005632:Fructose; D013656:Taurocholic Acid; D000362:Agar; D003523:Cycloserine