Clostridium Difficile

Clostridium Difficile Testing and Treatment

Asymptomatic colonization is present when the patient’s stool tests positive for C. difficile and/or its toxins (A and/or B) in the absence of clinical symptoms.
Asymptomatic colonization with C. difficile is more common than C. difficile infection and in most cases, should not be treated.
C. difficile infection describes a condition in which a patient’s stool tests positive for C. difficile bacteria or its toxins in the presence of clinical symptoms of infection.

Only watery or loose stools should be collected and tested
Specimens should be submitted in a clean, watertight container. Transport media is not necessary.
Specimens should be transported as soon as possible and stored at 2oC to 8oC until tested.
C. difficile toxin degrades at room temperature and may be undetectable within 2 hours after collection of a stool specimen.
False-negative results occur when specimens are not promptly tested or kept refrigerated until testing can be done.
Laboratory Tests for Clostridum difficile Infection (PDF 124KB/1 page)
Testing table summary.
Clostridium difficile Infection (CDI) Testing Recommendations: Recommendations for stool collection and submission (PDF: 110KB/1 page)
Do's and don'ts for Clostridium difficile testing.

Stopping the inciting antibiotic results in resolution of symptoms in approximately 25% of CDI patients.
If symptoms do not resolve within 2-3 days after the discontinuation of the inciting antibiotic, administration of an appropriate course of antibiotics (usually metronidazole or vancomycin administered orally) is recommended.
Treatment recommendations:
- SHEA Guidelines and White Papers
  For treatment recommendations refer to the SHEA guidelines. Attention: Non-MDH link
- MDH staff are available to provide clinical consultation regarding diagnosis and management of C. difficile. Call 651-201-5414 (toll free 1-877-676-5414).

After treatment, repeat C. difficile testing is not recommended for at least one month if the patients’ symptoms have resolved as patient may remain colonized.

Hand Hygiene
Information about washing/cleaning your hands.

If you have questions or comments about this page, use our IDEPC Comment Form or call 651-201-5414 (TTY: 651-201-5797) for the MDH Infectious Disease Epidemiology, Prevention and Control Division.