Clostridium difficile is thought to be present in up to a fifth of hospital patients, and can cause the life-threatening condition PMC. Oxoid reports continuing sales growth for its diagnostic test
Clostridium difficile was first described in 1935 but it was not until the 1970s that links were made between the organism and disease.
The organism is carried by 3% of healthy humans and 10-20% of hospital patients, but it is not until the normal gut flora gets disturbed by antibiotics that problems arise.
Under these circumstances, C difficile can establish itself in the colon and produce toxins that cause mucosal damage, inflammation and fluid secretion.
The affected person can exhibit a range of clinical syndromes from a mild, self limiting antibiotic associated diarrhoea, to a life-threatening condition, pseudomembranous colitis (PMC).
PMC is so named because of the gross changes to the colon surface forming characteristic lesions called pseudomembranes.
C difficile infection is mainly nosocomially acquired and is very much associated with elderly and immunocompromised people.
The organism may cause outbreaks of illness by spreading directly from patient to patient or being acquired from the environment and from healthcare workers.
C difficile causes disease by the action of two toxins, A and B.
In most cases of antibiotic associated diarrhoea and PMC, both toxins are thought to be present.
The number of reports of toxin positive stool samples reported to the Public Health Laboratory Service for England and Wales has increased enormously over the last 10 years.
Oxoid has offered a rapid screening test for C difficile toxin A since 1997, and sales have increased dramatically during this period, with 2001 being 27% higher than the same period last year.
The Oxoid test is simple and rapid with results available within about 45 minutes.
A sample preparation protocol involving a 10 minute centrifugation step is followed by placing the sample onto the test device and leaving for 30 minutes before reading the result.
An alternative sample preparation protocol is also possible.
This replaces centrifugation with a filtration step, carried out with a special device also available from Oxoid.
Using this technique the test procedure is even simpler and more rapid.
