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Clostridium difficile Toxin
Aka: Clostridium difficile Toxin, C. diff Toxin
- See Also
- Clostridium difficile
- Indications for testing
- Diarrheal stools and
- Antibiotic exposure in last 3 months
- Testing not indicated
- Solid stools
- Suggests asymptomatic carrier
- No benefit to treating carriers
- Re-evaluation after treatment
- Carriage is common for 3-6 weeks post-treatment
- Specimen
- Immediate exam of fresh stool specimen
- May be kept refrigerated if exam delayed
- Available tests
- Tissue culture Cytotoxicity Assay (Gold Standard)
- Test Sensitivity: 67-100%
- Test Specificity: 85-100%
- Expensive and requires 2 day incubation
- Enzyme Immunoassay for Toxins A and B
- Test Sensitivity: 63-99% (most are 85-95% sensitive)
- Test Specificity: 93-100%
- Inexpensive and results available within 2-6 hours
- New tests (still in development)
- C. difficile combination assay
- Glutamate dehydrogenase: 97% sensitivity
- Toxins A and B: 97-99% Specificity
- Tests not recommended for routine screening
- Latex agglutination assay (low accuracy)
- C. difficile culture (non-specific)
- Toxin A or B PCR (expensive and time intensive)
- References
- Brazier (1998) J Antimicrob Chemother 41:29-40 [PubMed]
- Kyne (2001) Gastroenterol Clin North Am 30(3):753-77 [PubMed]