Diagnosis of Clostridium difficile Colitis
Authors: Ferric C. Fang
Journal: Annals of Internal Medicine (1996)

Letters15 September 1996Diagnosis of Clostridium difficile ColitisFerric C. Fang, MD, Dale N. Gerding, MD, and Lance R. Peterson, MDFerric C. Fang, MDUniversity of Colorado Health Sciences Center, Denver, CO 80262Chicago Lakeside Veterans Affairs Medical Center, Chicago, IL 60611Search for more papers by this author, Dale N. Gerding, MDUniversity of Colorado Health Sciences Center, Denver, CO 80262Chicago Lakeside Veterans Affairs Medical Center, Chicago, IL 60611Search for more papers by this author, and Lance R. Peterson, MDUniversity of Colorado Health Sciences Center, Denver, CO 80262Chicago Lakeside Veterans Affairs Medical Center, Chicago, IL 60611Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-125-6-199609150-00021 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail TO THE EDITOR:We thank Manabe and colleagues [1] for their careful examination of the diagnostic aspects of C. difficile diarrhea. Although the case definition required a positive toxin assay result, the sensitivity of a single cytotoxin assay was only 79%. Using different case criteria, other investigators have found the sensitivity of cytotoxin assay to range from 67% to 74% [2].Manabe and coworkers report that diagnostic sensitivity may be increased by obtaining two to three serial stool specimens for cytotoxin assay. However, Aronsson and colleagues [3] reported that additional specimens increase the rate of detection by only 10%. We ...References1. Manabe YC, Vinetz JM, Moore RD, Merz C, Charache P, Bartlett JG. Clostridium difficile colitis: an efficient clinical approach to diagnosis. Ann Intern Med. 1995; 123:835-40. Google Scholar2. Peterson LR, Kelly PJ. The role of the clinical microbiology laboratory in the management of Clostridium difficile-associated diarrhea. Infect Dis Clin North Am. 1993; 7:277-93. Google Scholar3. Aronsson B, Mollby R, Nord CE. Diagnosis and epidemiology of Clostridium difficile enterocolitis in Sweden. J Antimicrob Chemother. 1984; 14(Suppl D):85-95. Google Scholar4. Gerding DN, Johnson S, Peterson LR, Mulligan ME, Silva J. Clostridium difficile-associated diarrhea and colitis: SHEA position paper. Infect Control Hosp Epidemiol. 1995; 16:459-88. Google Scholar5. Lashner BA, Todorczuk J, Sahm DF, Hanauer SB. Clostridium difficile culture-positive toxin-negative diarrhea. Am J Gastroenterol. 1986; 81:940-3. Google Scholar Author, Article, and Disclosure InformationAffiliations: University of Colorado Health Sciences Center, Denver, CO 80262Chicago Lakeside Veterans Affairs Medical Center, Chicago, IL 60611 PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited ByAntibiotic-Associated Colitis 15 September 1996Volume 125, Issue 6Page: 515KeywordsCytotoxinsDiarrheaNosocomial infectionsPathogensResearch laboratoriesToxins Issue Published: 15 September 1996 CopyrightCopyright © 1996 by American College of Physicians. All Rights Reserved.PDF DownloadLoading ...