After treatment with antibiotics, many patients develop gastrointestinal problems ranging from mild diarrhea to severe pseudomembranous colitis. Many cases of the milder forms of gastrointestinal illness and most cases of pseudomembranous colitis are caused by toxigenic strains of Clostridium difficile . This organism is an opportunistic anaerobic bacterium that grows in the intestine once the normal flora has been altered by
the antibiotic. Toxigenic strains of C. difficile carry the genes encoding the toxins while nontoxigenic strains do not carry the toxin genes. Disease onset is associated with the toxins that are produced by the toxigenic organism. The clinical symptoms associated with the disease are believed to be primarily due to toxin A, which is a tissue-damaging enterotoxin. C. difficile also produces a second toxin, designated toxin B. Toxin B, which has been referred to as the cytotoxin of the organism, is the toxin detected by the tissue culture assay currently used by many laboratories. Toxigenic C. difficile strains produce both toxins, or only toxin B. The glutamate dehydrogenase of C. difficile is a good antigen marker for the organism in feces because it is produced in high amounts by all strains, toxigenic or non-toxigenic. The antigen can be detected in fecal specimens by using
the C. DIFF QUIK CHEK COMPLETE test. A positive result in the test for the glutamate dehydrogenase of C. difficile confirms the presence of this organism in a fecal specimen; a negative result indicates the absence of the organism. A positive result in the test for toxins A and B confirms the presence of toxigenic C. difficile
Manufacturer’s Reagent package insert, TECHLAB® C.DIFF QUIK CHEK COMPLETE® 2016/07, TECHLAB, Inc., 2001 Kraft Drive Blacksburg, VA 24060-6358, USA.