Selective and differential medium for isolation of Clostridium difficile.
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A selective and differential agar medium that contains cycloserine, cefoxitin, fructose, and egg yolk (CCFA) was developed to facilitate the isolation of C. difficile from fecal specimens and was found to be the most sensitive and selective of these media for the recovery of the bacterium.Abstract:
Clostridium difficile is a recognized cause of pseudomembranous (antimicrobial agent-associated) colitis and may be one of the causes of antimicrobial agent-induced diarrhea. A selective and differential agar medium that contains cycloserine, cefoxitin, fructose, and egg yolk (CCFA) was developed to facilitate the isolation of C. difficile from fecal specimens. Quantitative cultures of 16 stock strains of C. difficile on this medium (and on a medium containing cycloserine, fructose, and egg yolk) yielded counts equivalent to those obtained on blood agar; other media selective for clostridia, including Clostrisel agar, reinforced clostridial agar plus 0.2% para-cresol, and egg yolk-neomycin agar (the latter was inoculated with cultures subjected to prior heat shocking), were also tested and found to be inhibitory to the growth of C. difficile. Of 28 fecal or colostomy effluent specimens cultured on the above media, 14 yielded C. difficile. CCFA was found to be the most sensitive and selective of these media for the recovery of C. difficile. Colonies of C. difficile growing on CCFA had distinctive morphological and fluorescent properties which were sufficient for presumptive identification. CCFA should provide a rapid method for the screening of fecal specimens from patients with antimicrobial agent-associated diarrhea or colitis for C. difficile.read more
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Journal ArticleDOI
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)
Stuart H. Cohen,Dale N. Gerding,Stuart Johnson,Ciaran P. Kelly,Vivian G. Loo,L. Clifford McDonald,Jacques Pépin,Mark H. Wilcox +7 more
TL;DR: This guideline updates recommendations regarding epidemiology, diagnosis, treatment, and infection control and environmental management of Clostridium difficile.
Journal ArticleDOI
Asymptomatic Carriage of Clostridium difficile and Serum Levels of IgG Antibody against Toxin A
TL;DR: There is no evidence of immune protection against colonization by C. difficile in hospitalized patients who were receiving antibiotics, but after colonization there is an association between a systemic anamnestic response to toxin A, as evidenced by increased serum levels of IgG antibody against toxins A, and asymptomatic carriage of C.difficile.
Journal ArticleDOI
Prospective randomised trial of metronidazole versus vancomycin for clostridium-difficile-associated diarrhoea and colitis
DavidG. Teasley,MaryM. Olson,RogerL. Gebhard,DaleN. Gerding,Lancer R. Peterson,MichaelJ. Schwartz,JamesT. Lee +6 more
TL;DR: Metronidazole and vancomycin have equivalent efficacy and relapse rates and are tolerated to a similar extent by patients with C-difficile-related diarrhoea and colitis, but metronidrazole is considerably more economical.
Journal ArticleDOI
Clostridium difficile-associated diarrhea and colitis
TL;DR: The status of diagnosis, epidemiology, infection control, and treatment of Clostridium difficile -associated disease is reviewed and a case definition of CDAD is defined.
Journal ArticleDOI
Clostridium difficile: its disease and toxins.
TL;DR: There appears to be a cascade of events which result in the expression of the activity of these toxins, and these events, ranging from the recognition of a trisaccharide receptor by toxin A to the synergistic action of the toxins and their possible dissemination in the body, are discussed in this review.
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Clindamycin-Associated Colitis Due to a Toxin-Producing Species of Clostridium in Hamsters
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TL;DR: Three patients who had severe, protracted colitis associated with treatment with the drug clindamycin hydrochloride hydrate are reported.
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TL;DR: Data implicate the toxin of C. difficile as a major, and perhaps the sole, cause of antimicrobial-agent-associated P.M.C. of man and suggest that the neutralisation of the faecal toxin of P.Sordellii antitoxin may be a non-specific phenomenon.
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