Nontoxigenic Clostridium difficile: A Source for Hospital Infection?

Among samples obtained from symptomatic patients, toxin-positive strains were three times more likely to be associated with subsequent transmission than toxin-negative strains.

The source of Clostridium difficile disease (CDI) in hospitals has not been resolved. In studies using whole gene sequencing (WGS), only about one third of hospital-acquired cases were genetically linked to a previous symptomatic hospital case. Confounding this issue is confusion about defining CDI. In the U.S., nucleic acid amplification tests (NAATs) alone are generally used to identify CDI in patients with diarrhea. However, increasingly, NAAT positivity is understood to indicate only carriage of the organism. To ascertain disease, a toxin assay on a stool sample, either by an enzyme immunoassay (EIA) or a cell cytotoxicity assay (CCA), is additionally required.

To assess the role of toxin-producing and nontoxigenic C. difficile on hospit…

Reviewing Author

Neil M. Ampel, MD

Disclosures

Editorial BoardsUpToDate

Leadership Positions in Professional SocietiesCoccidioidomycosis Study Group (Past President, Secretary, Treasurer)

Neil M. Ampel, MD

Disclosures

Editorial BoardsUpToDate

Leadership Positions in Professional SocietiesCoccidioidomycosis Study Group (Past President, Secretary, Treasurer)

Nontoxigenic Clostridium difficile: A Source for Hospital Infection?

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Reviewing Author