Clostridium Difficile
Diagnosis of Clostridium Difficile
INTRODUCTION
Clostridium Difficile Infection is currently the most commonly found cause of diarrhoea in relation to antibiotic treatments in hospitals. Although C.difficile infections are common, there are only a limited methods of diagnosing accurately if a patient has been affected. I will be discussing methods of diagnosis, pros and cons and statistical facts regarding C.difficile infection.
METHODS OF LABORATORY DIAGNOSIS
There are several methods of diagnosing if a patient is infected by C.difficile Although there are 5 different methods of detection which could in theory lead to a positive diagnosis; but only three out of the five, faecal-cytotoxin detection (Mollby R et al 1985), toxigenic culture detection and direct gas liquid chromatography (GLC), are considered to be procedures providing firm positive result for standard diagnosis to be made (BRAZIER 1998). The other two, Latex agglutination and computed tomography scan are also tests carried out to diagnose the presence of C.difficile, but they are insufficiently sensitive nor specific on their own thus these tests are commonly used in conjunction with other methods of testing.
In order for a precise bacteriological diagnosis, stool samples provided must be in the form of a liquid, freshly obtained and kept at 4°C or less. The test sample must be fresh and kept at low temperatures due to the fact that the cytotoxin activity drastically decreases over time, 20% of samples sent by post were completely inactivated according to results reported by Brazier, therefore increasing the probability of a false result being obtained. (BRAZIER 1998)
DEPENDANCE ON PRIMARY SYMPTOMS IN DIAGNOSIS OF A PATIENT
Patients maybe diagnosed with C.difficile infection if they produce diarrhoea or liquid-stools of more than 300ml in a period of 24 hours (JOHN STARR BMJ). Even though main symptoms of C.difficile infection includes chronic diarrhoea, it is not
INTRODUCTION
Clostridium Difficile Infection is currently the most commonly found cause of diarrhoea in relation to antibiotic treatments in hospitals. Although C.difficile infections are common, there are only a limited methods of diagnosing accurately if a patient has been affected. I will be discussing methods of diagnosis, pros and cons and statistical facts regarding C.difficile infection.
METHODS OF LABORATORY DIAGNOSIS
There are several methods of diagnosing if a patient is infected by C.difficile Although there are 5 different methods of detection which could in theory lead to a positive diagnosis; but only three out of the five, faecal-cytotoxin detection (Mollby R et al 1985), toxigenic culture detection and direct gas liquid chromatography (GLC), are considered to be procedures providing firm positive result for standard diagnosis to be made (BRAZIER 1998). The other two, Latex agglutination and computed tomography scan are also tests carried out to diagnose the presence of C.difficile, but they are insufficiently sensitive nor specific on their own thus these tests are commonly used in conjunction with other methods of testing.
In order for a precise bacteriological diagnosis, stool samples provided must be in the form of a liquid, freshly obtained and kept at 4°C or less. The test sample must be fresh and kept at low temperatures due to the fact that the cytotoxin activity drastically decreases over time, 20% of samples sent by post were completely inactivated according to results reported by Brazier, therefore increasing the probability of a false result being obtained. (BRAZIER 1998)
DEPENDANCE ON PRIMARY SYMPTOMS IN DIAGNOSIS OF A PATIENT
Patients maybe diagnosed with C.difficile infection if they produce diarrhoea or liquid-stools of more than 300ml in a period of 24 hours (JOHN STARR BMJ). Even though main symptoms of C.difficile infection includes chronic diarrhoea, it is not