The role of the clinical microbiology laboratory in the management of Clostridium difficile-associated diarrhea.

Nosocomial diarrhea due to infection with C. difficile is a major health care problem, causing 20% to 30% of institutionally acquired diarrhea and affecting up to 8% of hospitalized patients. The clinical microbiology laboratory should be able to provide both diagnostic and epidemiologic services for institutions where this disease occurs. Diagnostic testing includes culture for isolation of toxigenic C. difficile and detection of either toxin A or B from stool specimens. Epidemiologic services include providing appropriate media and specimen preparation for surveillance activities and performance of accurate typing of C. difficile strains when necessary to determine organism relatedness for development of effective infection control practices.