1887

Abstract

The culture of toxigenic from stool specimens is still seen as the gold standard for the laboratory diagnosis of infection (CDI). bioMérieux have released ChromID Cdiff chromogenic agar (CDIF) for the isolation and identification of in 24 h. In this study, we compared CDIF to pre-reduced cycloserine-cefoxitin-fructose agar with sodium taurocholate (TCCFA) in the examination of glutamate dehydrogenase-positive faecal specimens that were either GeneOhm positive or negative, using direct culture or culture following alcohol shock. Direct culture on CDIF had a sensitivity of 100 % and recovery of 94 % while for TCCFA these were 87 % and 82 %, respectively. For GeneOhm-positive alcohol-shocked faecal samples, sensitivity and recovery on CDIF was similar to direct culture while on TCCFA they were about 10 % higher. For direct culture, there was a significant difference between growth on CDIF at 24 h and TCCFA at 48 h 0.001) and between the two media at 48 h (<0.001). A total of 142 strains of were recovered in pure culture from all GeneOhm-positive samples used in this study and 11 (7.7 %) of these were ABCDT and may represent mixed infections of toxigenic and non-toxigenic . The most dominant ribotype was UK 014 (14.7 %) followed by 002 (11.9 %) and 020 (11.9 %), and 36 % of toxigenic isolates, including an ABCDT strain, could not be assigned a UK ribotype. CDIF outperformed pre-reduced TCCFA by negating the need for alcohol shock treatment and by giving a time saving of 24 h in the isolation of . CDIF plates were also more selective than TCCFA and colonies were easy to identify and subculture prior to strain typing.

  • This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Loading

Article metrics loading...

/content/journal/jmm/10.1099/jmm.0.056515-0
2013-09-01
2024-03-28
Loading full text...

Full text loading...

/deliver/fulltext/jmm/62/9/1423.html?itemId=/content/journal/jmm/10.1099/jmm.0.056515-0&mimeType=html&fmt=ahah

References

  1. Boseiwaqa L. V., Foster N. F., Thean S. K., Squire M. M., Riley T. V., Carson K. C. 2013 Comparison of ChromID C. difficile agar and cycloserine cefoxitin fructose agar for the characterization and recovery of Clostridium difficile. Pathol (in press) [View Article][PubMed]
  2. Cohen S. H., Gerding D. N., Johnson S., Kelly C. P., Loo V. G., McDonald L. C., Pepin J., Wilcox M. H.Society for Healthcare Epidemiology of AmericaInfectious Diseases Society of America 2010; Clinical practice guidelines for Clostridium difficile infection in adults: 2010 update by the society for healthcare epidemiology of America (SHEA) and the infectious diseases society of America (IDSA). Infect Control Hosp Epidemiol 31:431–455 [View Article][PubMed]
    [Google Scholar]
  3. Debast S. B., van Leengoed L. A. M. G., Goorhuis A., Harmanus C., Kuijper E. J., Bergwerff A. A. 2009; Clostridium difficile PCR ribotype 078 toxinotype V found in diarrhoeal pigs identical to isolates from affected humans. Environ Microbiol 11:505–511 [View Article][PubMed]
    [Google Scholar]
  4. Eckert C., Burghoffer B., Lalande V., Barbut F. 2013; Evaluation of the chromogenic agar chromID C. difficile. J Clin Microbiol 51:1002–1004 [View Article][PubMed]
    [Google Scholar]
  5. Eyre D. W., Walker A. S., Griffiths D., Wilcox M. H., Wyllie D. H., Dingle K. E., Crook D. W., Peto T. E. A. 2012; Clostridium difficile mixed infection and reinfection. J Clin Microbiol 50:142–144 [View Article][PubMed]
    [Google Scholar]
  6. Fenner L., Widmer A. F., Goy G., Rudin S., Frei R. 2008; Rapid and reliable diagnostic algorithm for detection of Clostridium difficile.. J Clin Microbiol 46:328–330 [View Article][PubMed]
    [Google Scholar]
  7. George W. L., Sutter V. L., Citron D., Finegold S. M. 1979; Selective and differential medium for isolation of Clostridium difficile.. J Clin Microbiol 9:214–219[PubMed]
    [Google Scholar]
  8. Goorhuis A., Bakker D., Corver J., Debast S. B., Harmanus C., Notermans D. W., Bergwerff A. A., Dekker F. W., Kuijper E. J. 2008; Emergence of Clostridium difficile infection due to a new hypervirulent strain, polymerase chain reaction ribotype 078. Clin Infect Dis 47:1162–1170 [View Article][PubMed]
    [Google Scholar]
  9. Kato N., Ou C. Y., Kato H., Bartley S. L., Brown V. K., Dowell V. R. Jr, Ueno K. 1991; Identification of toxigenic Clostridium difficile by the polymerase chain reaction. J Clin Microbiol 29:33–37[PubMed]
    [Google Scholar]
  10. Perry J. D., Asir K., Halimi D., Orenga S., Dale J., Payne M., Carlton R., Evans J., Gould F. K. 2010; Evaluation of a chromogenic culture medium for isolation of Clostridium difficile within 24 hours. J Clin Microbiol 48:3852–3858 [View Article][PubMed]
    [Google Scholar]
  11. Riley T. 2012; An outbreak of community-acquired Clostridium difficile infection in Australia, 2011–12. In International Clostridium difficile Symposium 2012 Bled, Slovenia:
    [Google Scholar]
  12. Schmidt M. L., Gilligan P. H. 2009; Clostridium difficile testing algorithms: what is practical and feasible?. Anaerobe 15:270–273 [View Article][PubMed]
    [Google Scholar]
  13. Shin B. M., Kuak E. Y., Lee E. J., Songer J. G. 2009; Algorithm combining toxin immunoassay and stool culture for diagnosis of Clostridium difficile infection. J Clin Microbiol 47:2952–2956 [View Article][PubMed]
    [Google Scholar]
  14. Stubbs S. L. J., Brazier J. S., O’Neill G. L., Duerden B. I. 1999; PCR targeted to the 16S-23S rRNA gene intergenic spacer region of Clostridium difficile and construction of a library consisting of 116 different PCR ribotypes. J Clin Microbiol 37:461–463[PubMed]
    [Google Scholar]
  15. Stubbs S., Rupnik M., Gibert M., Brazier J., Duerden B., Popoff M. 2000; Production of actin-specific ADP-ribosyltransferase (binary toxin) by strains of Clostridium difficile.. FEMS Microbiol Lett 186:307–312 [View Article][PubMed]
    [Google Scholar]
  16. Warny M., Pepin J., Fang A., Killgore G., Thompson A., Brazier J., Frost E., McDonald L. C. 2005; Toxin production by an emerging strain of Clostridium difficile associated with outbreaks of severe disease in North America and Europe. Lancet 366:1079–1084 [View Article][PubMed]
    [Google Scholar]
http://instance.metastore.ingenta.com/content/journal/jmm/10.1099/jmm.0.056515-0
Loading
/content/journal/jmm/10.1099/jmm.0.056515-0
Loading

Data & Media loading...

This is a required field
Please enter a valid email address
Approval was a Success
Invalid data
An Error Occurred
Approval was partially successful, following selected items could not be processed due to error