Stool C. difficile toxin

• How the test is performed

  A sample of a stool is submitted for laboratory analysis. There are several methods used to detect C. difficile toxin in the stool specimen.

  Today, an enzyme immunoassay (EIA) is most often used to detect substances produced by the bacteria. The EIA is faster than previous culture tests, simpler to perform, and results are available in about an hour. However, it is slightly less sensitive than previous methods. Several stool samples may be needed to get an accurate result.

• How to prepare for the test

  There are many ways to collect the samples. You can catch the stool on plastic wrap that is loosely placed over the toilet bowl and held in place by the toilet seat. Then you put the sample in a clean container. One test kit supplies a special toilet tissue that you use to collect the sample. After collecting the sample, you put it in a container.

  Do not mix urine, water, or toilet tissue with the sample.

  For children wearing diapers, you can line the diaper with plastic wrap. If the plastic wrap is positioned properly, it will prevent urine and stool from mixing to provide a better sample.

• How the test will feel

  There is no discomfort.

• Why the test is performed

  You may have this test if your doctor suspects that diarrhea is caused by recent antibiotic use. Antibiotics change the balance of bacteria in the colon. This sometimes leads to too much growth of C. difficile.

  Diarrhea caused by C. difficile after antibiotic use often occurs in hospitalized patients. It also can occur in people who have not recently taken antibiotics.

• Normal Values

  No C. difficile toxin is detected.

  Note: Normal value ranges may vary slightly among different laboratories. Talk to your doctor about the meaning of your specific test results.

• What abnormal results mean

  Abnormal results mean that C. difficile toxins are likely present in the stool and are causing diarrhea.

• What the risks are

  There are no risks associated with testing for C. difficile toxin.

• Special considerations

  Since the test for C. difficile toxin is not 100% sensitive, several stool samples may be needed to detect it.

• References

  Bartlett JG. Clostridial infections. In: Goldman L, Ausiello D, eds. Cecil Medicine. 23rd ed. Philadelphia, Pa: Saunders Elsevier; 2007: chap 319.

Review Date: 11/2/2008

Reviewed By: David C. Dugdale, III, MD, Professor of Medicine, Division of General Medicine, Department of Medicine, University of Washington School of Medicine; and George F. Longstreth, MD, Department of Gastroenterology, Kaiser Permanente Medical Care Program, San Diego, California. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.