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Stool C difficile toxin

Antibiotic associated colitis - toxin; Colitis - toxin; Pseudomembranous colitis - toxin; Necrotizing colitis - toxin; C difficile - toxin

The stool C difficile toxin test detects harmful substances produced by the bacterium Clostridioides difficile (C difficile). This infection is a common cause of diarrhea after antibiotic use.

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Clostridium difficile organism

How the Test is Performed

A stool sample is needed. It is sent to a lab to be analyzed. There are several ways to detect C difficile toxin in the stool sample.

Enzyme immunoassay (EIA) is most often used to detect substances produced by the bacteria. This test is faster than older tests, and simpler to perform. The results are ready in a few hours. However, it is slightly less sensitive than earlier methods. Several stool samples may be needed to get an accurate result.

A newer method is to use PCR to detect the toxin genes. This is the most sensitive and specific test. Results are ready within 1 hour. Only one stool sample is needed.

How to Prepare for the Test

There are many ways to collect the samples.

Do not mix urine, water, or toilet tissue with the sample.

For children wearing diapers:

Why the Test is Performed

You may have this test if your health care provider thinks that diarrhea is caused by the antibiotic medicines you have taken recently. Antibiotics change the balance of bacteria in the colon. This sometimes leads to too much growth of C difficile.

Diarrhea caused by C difficile after antibiotic use often occurs in people who are in the hospital. It also can occur in people who have not recently taken antibiotics. This condition is called pseudomembranous colitis.

Normal Results

No C difficile toxin is detected.

Note: Normal value ranges may vary slightly among different laboratories. Talk to your provider about the meaning of your specific test results.

What Abnormal Results Mean

Abnormal results mean that toxins produced by C difficile are seen in the stool and are causing diarrhea.

Risks

There are no risks associated with testing for C difficile toxin.

Considerations

Several stool samples may be needed to detect the condition. This is particularly true if the older EIA for toxin test is used.

Related Information

Diarrhea

References

Beavis KG, Charnot-Katsikas A. Specimen collection and handling for diagnosis of infectious diseases. In: McPherson RA, Pincus MR, eds. Henry's Clinical Diagnosis and Management by Laboratory Methods. 23rd ed. St Louis, MO: Elsevier; 2017:chap 64.

Burnham C-A D, Storch GA. Diagnostic microbiology. In: Kliegman RM, St. Geme JW, Blum NJ, Shah SS, Tasker RC, Wilson KM, eds. Nelson Textbook of Pediatrics. 21st ed. Philadelphia, PA: Elsevier; 2020:chap 195.

Gerding DN, Johnson S. Clostridial infections. In: Goldman L, Schafer AI, eds. Goldman-Cecil Medicine. 26th ed. Philadelphia, PA: Elsevier; 2020:chap 280.

Gerding DN, Young VB, Donskey CJ. Clostridioides difficile (formerly Clostridium difficle) infection. In: Bennett JE, Dolin R, Blaser MJ, eds. Mandell, Douglas, and Bennett's Principles and Practice of Infectious Diseases. 9th ed. Philadelphia, PA: Elsevier; 2020:chap 243.

Siddiqi HA, Salwen MJ, Shaikh MF, Bowne WB. Laboratory diagnosis of gastrointestinal and pancreatic disorders. In: McPherson RA, Pincus MR, eds. Henry's Clinical Diagnosis and Management by Laboratory Methods. 23rd ed. St Louis, MO: Elsevier; 2017:chap 22.

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Review Date: 4/7/2020  

Reviewed By: Michael M. Phillips, MD, Clinical Professor of Medicine, The George Washington University School of Medicine, Washington, DC. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.

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