Education & Training, Microbiology, Test Spotlight

Only Liquid/Loose Stools Should be Sent for C-Diff Testing

When testing for Clostridium difficile Toxin (“C-diff”), only liquid/loose (i.e. watery) stools should be sent for testing. Any formed or soft stools will be immediately rejected and testing will be canceled.

In order to increase quality of care for our patients and decrease the overuse of antibiotics, when ordering Clostridium difficile Toxin and  Clostridium difficile Toxin, PCR, remember these important notes!

  • Only test symptomatic patients; diarrhea with 3 or more liquid (i.e. watery), loose, unformed stools in 24 hours or less.

Testing of asymptomatic patients is not clinically useful. For example, testing of asymptomatic patients will only detect colonization and not disease. Treatment of colonization is not possible or recommended

Testing for “Test of Cure” is also inappropriate. It only results in unnecessary treatment and creates anxiety for the patient and providers.

  • Do not test patients who are having liquid/loose stools for known reasons (i.e. laxatives).
  • Only one specimen is necessary for detection of toxigenic C. difficile.

If PCR is negative, repeat testing within 7 days is not recommended.

  • Test information has not been established for patients less than 2 years of age.

Up to 50% of infants less than 2 years asymptomatically carry C. difficile and its toxins.Clostridium difficile (C diff)

Please refer to this article provided by Infectious Disease Specialist, Dr. David Dobbie:

Clostridium difficile infection in adults: Clinical manifestations and diagnosis. Lamont, J Thomas, MD. “UpToDate”. December 2015

If you cannot access this article, a version can be emailed to you. Please contact Spectrum Health Laboratory.

Patient Stool Collection Instructions may be found in the Laboratory Catalog.


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