Guidelines
C. difficile Testing

C. difficile Testing

Scenario

Patient presents with ≥3 loose stools in ≤24 hr and there is no other explanation for diarrhea (e.g. laxatives, tube feeds)

Step #1

  • EIA (enzyme immunoassay) screens for an antigen and toxins
  • The antigen is very sensitive, but does not distinguish between toxigenic and non-toxigenic strains
  • The sensitivity for toxin is 52-75%, which increases with a higher toxin load

More Information

If stool collected on day 4 or greater of inpatient admission and either EIA is positive for both antigen/toxin, OR EIA is indeterminate with toxin PCR positive: C. difficile will be categorized as hospital onset C. difficile (HO-Cdiff)

Polage CR, et al. JAMA Intern Med 2015;175(11):1792-1801.