Clostridium difficile in adult patients with nosocomial diarrhea in a Costa Rican hospital.

Stool samples from 104 adult patients with nosocomial antibiotic-associated diarrhea were analyzed for Clostridium difficile by cultivation, toxin A inmunoenzymatic detection, and toxin B cytotoxic detection. The isolates were additionally screened for the toxin genes by polymerase chain reaction. C. difficile was isolated from 26 samples, and the toxins were directly detected in another 5 samples. Toxin A and B genes were detected in all toxigenic bacterial isolates. The detection rate of 30% indicates that C. difficile is a major etiologic agent of nosocomial diarrhea in Costa Rica.