C Difficile Toxins A+B, EIA

Test ID: 

705722

CPT code:

87324

Synonyms:

Antibiotic-associated Colitis Toxin Test
Pseudomembranous Colitis Toxin Assay

Clinical Use:

Aid in the diagnosis of antibiotic-associated diarrheal disease and pseudomembranous colitis

Additional Test Information:

C difficile can produce two toxins, designated A and B, that have pathogenic effects in humans. Antibiotic-associated pseudomembranous colitis has been shown to result from the action of these two toxins. This disease has been associated with clindamycin use but it is now recognized that pseudomembranous colitis can follow administration of virtually any antibiotic. More than 70% of the cases in a large series were associated with cephalosporin therapy.1 The clinical spectrum of antibiotic-induced syndromes caused by C difficile includes patients with symptoms of acute abdomen with little or no diarrhea, as well as cases with fulminant life-threatening diarrhea. Nosocomial transmission and reinfection with different strains occurs as do spontaneous cases without prior antimicrobial therapy. In cases where cessation of antibiotic therapy does not produce a response, specific therapy with oral vancomycin, metronidazole, or oral bacitracin may be effective. Detection of the toxins produced by C difficile (rather than culture of the organism) is important in the determining therapy of this potentially fatal disease. The routine use of culture does not seem appropriate because of the costs and the high rate of recovery of strains which do not produce toxin.

Specimen Type:

Stool

Requested Volume: 

5 g

Minimum Volume: 

0.5 g or 0.5 mL liquid stool

Container Type: 

Sterile screw-cap container or stool transport without preservatives (Para-Pak® white clean vial). “Cool Whip” containers, denture cups, or other similar containers often leak or even explode during transport and may be rejected by the laboratory

Storage Instructions:

Specimen should be kept refrigerated and transported to the laboratory within 24 hours of collection. If a longer period is required, the specimen should be frozen at -70°C on dry ice.

Rejection Criteria

Inappropriate specimen transport conditions (eg, room temperature) or transport device; unlabeled specimen or name discrepancy between specimen and request label; specimen received after prolonged delay (usually more than 72 hours); specimens other than stool; leaking specimen; specimen received in denture cup, “Cool Whip” container, margarine container, or similar container

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