Clostridium difficile is one of the most frequent pathogens in nosocomial infections – but in spite of this many people have never heard of it. Since November is officially “Clostridium difficile Awareness Month,” we have compiled a summary of what you should know about the hospital pathogen.
Clostridium difficile infection is one of the most frequent nosocomial infections, but even outside of hospitals the bacterium is a frequent cause of diarrhea and severe complications such as toxic megacolon. Not all patients that exhibit colonization with Clostridium difficile develop diarrhea however. In healthy persons, the intestinal bacterium is harmless. Illness only flares up if the natural intestinal flora is disturbed, e.g., by ingestion of antibiotics, or if the ingestion of proton pump inhibitors reduces stomach acidity. This enables the bacterium to reproduce more rapidly and to produce toxins that are the main cause of the onset of symptoms. In many patients (up to 50 %) there is a relapse, a so-called recurrence. The risk of suffering from another recurrence increases with each additional relapse.
Diagnosis algorithm
The great risk of nosocomial transmission and of potentially fatal disease progression means that a rapid and certain diagnosis is necessary. One option for this is the detection of the Clostridium difficile-specific enzyme glutamate dehydrogenase (GDH). This method is rapid and sensitive, but not sufficiently specific, since also non-toxigenic strains are detected. Hence a two-phase diagnosis is useful: If the result of the GDH test is positive, then a specific detection of A and B toxins follows. If the GDH test is negative, then a Clostridium difficile infection can very probably be ruled out.
R-Biopharm offers comprehensive diagnostic solutions for the currently recommended diagnosis algorithms:
