Clostridium difficilein general practice and community health

Abstract

SUMMARY: The isolation rate forClostridium difficilein diarrhoeal stools was investigated in patients from general practice and community health centres over a 14-month period.C. difficileor its cytotoxin was detected in specimens from 89 (4·7 %) of 1882 patients studied and accounted for 30·3 % of all enteropathogenic micro-organisms isolated. OverallC. difficilewas second only toGiandia lambliain frequency. Recovery rates in the different groups of patients surveyed varied from 3·6 to 27·5 %. The relationship between stool culture results and stool cytotoxin assay also varied considerably between groups of patients studied. Coincident infections with a variety of enteropathogenic bacteria and intestinal parasites were diagnosed in 14 of the 89 patients. It was concluded that laboratories servicing this type of practice should be aware thatC. difficilemay be a cause of diarrhoea. An adequate clinical history should facilitate proper processing of the specimen.