This Article Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Services Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Copyright Information Books from ASM Press MicrobeWorld Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by George, W L Articles by Finegold, S M Search for Related Content PubMed PubMed Citation Articles by George, W L Articles by Finegold, S M

Selective and differential medium for isolation of Clostridium difficile.

ABSTRACT

Clostridium difficile is a recognized cause of pseudomembranous (antimicrobial agent-associated) colitis and may be one of the causes of antimicrobial agent-induced diarrhea. A selective and differential agar medium that contains cycloserine, cefoxitin, fructose, and egg yolk (CCFA) was developed to facilitate the isolation of C. difficile from fecal specimens. Quantitative cultures of 16 stock strains of C. difficile on this medium (and on a medium containing cycloserine, fructose, and egg yolk) yielded counts equivalent to those obtained on blood agar; other media selective for clostridia, including Clostrisel agar, reinforced clostridial agar plus 0.2% para-cresol, and egg yolk-neomycin agar (the latter was inoculated with cultures subjected to prior heat shocking), were also tested and found to be inhibitory to the growth of C. difficile. Of 28 fecal or colostomy effluent specimens cultured on the above media, 14 yielded C. difficile. CCFA was found to be the most sensitive and selective of these media for the recovery of C. difficile. Colonies of C. difficile growing on CCFA had distinctive morphological and fluorescent properties which were sufficient for presumptive identification. CCFA should provide a rapid method for the screening of fecal specimens from patients with antimicrobial agent-associated diarrhea or colitis for C. difficile.

This article has been cited by other articles:

• Gerber, M., Walch, C., Loffler, B., Tischendorf, K., Reischl, U., Ackermann, G. (2008). Effect of sub-MIC concentrations of metronidazole, vancomycin, clindamycin and linezolid on toxin gene transcription and production in Clostridium difficile. J Med Microbiol 57: 776-783 [Abstract] [Full Text]  
• Novak-Weekley, S. M., Hollingsworth, M. H. (2008). Comparison of the Premier Toxin A and B Assay and the TOX A/B II Assay for Diagnosis of Clostridium difficile Infection. CVI 15: 575-578 [Abstract] [Full Text]  
• Keel, M. K., Songer, J. G. (2007). The Distribution and Density of Clostridium difficile Toxin Receptors on the Intestinal Mucosa of Neonatal Pigs. Vet Pathol 44: 814-822 [Abstract] [Full Text]  
• Reller, M. E., Lema, C. A., Perl, T. M., Cai, M., Ross, T. L., Speck, K. A., Carroll, K. C. (2007). Yield of Stool Culture with Isolate Toxin Testing versus a Two-Step Algorithm Including Stool Toxin Testing for Detection of Toxigenic Clostridium difficile. J. Clin. Microbiol. 45: 3601-3605 [Abstract] [Full Text]  
• Jump, R. L. P., Pultz, M. J., Donskey, C. J. (2007). Vegetative Clostridium difficile Survives in Room Air on Moist Surfaces and in Gastric Contents with Reduced Acidity: a Potential Mechanism To Explain the Association between Proton Pump Inhibitors and C. difficile-Associated Diarrhea?. Antimicrob. Agents Chemother. 51: 2883-2887 [Abstract] [Full Text]  
• Keel, K., Brazier, J. S., Post, K. W., Weese, S., Songer, J. G. (2007). Prevalence of PCR Ribotypes among Clostridium difficile Isolates from Pigs, Calves, and Other Species. J. Clin. Microbiol. 45: 1963-1964 [Abstract] [Full Text]  
• Jackson, S., Calos, M., Myers, A., Self, W. T. (2006). Analysis of Proline Reduction in the Nosocomial Pathogen Clostridium difficile. J. Bacteriol. 188: 8487-8495 [Abstract] [Full Text]  
• Keel, M. K., Songer, J. G. (2006). The Comparative Pathology of Clostridium difficile-associated Disease. Vet Pathol 43: 225-240 [Abstract] [Full Text]  
• Poxton, I. R (2005). Clostridium difficile. J Med Microbiol 54: 97-100 [Full Text]  
• Ackermann, G., Thomalla, S., Ackermann, F., Schaumann, R., Rodloff, A. C, Ruf, B. R (2005). Prevalence and characteristics of bacteria and host factors in an outbreak situation of antibiotic-associated diarrhoea. J Med Microbiol 54: 149-153 [Abstract] [Full Text]  
• Delmee, M., Van Broeck, J., Simon, A., Janssens, M., Avesani, V. (2005). Laboratory diagnosis of Clostridium difficile-associated diarrhoea: a plea for culture. J Med Microbiol 54: 187-191 [Abstract] [Full Text]  
• Snell, H., Ramos, M., Longo, S., John, M., Hussain, Z. (2004). Performance of the TechLab C. DIFF CHEK-60 Enzyme Immunoassay (EIA) in Combination with the C. difficile Tox A/B II EIA Kit, the Triage C. difficile Panel Immunoassay, and a Cytotoxin Assay for Diagnosis of Clostridium difficile-Associated Diarrhea. J. Clin. Microbiol. 42: 4863-4865 [Abstract] [Full Text]  
• Tang-Feldman, Y., Mayo, S., Silva, J. Jr., Cohen, S. H. (2003). Molecular Analysis of Clostridium difficile Strains Isolated from 18 Cases of Recurrent Clostridium difficile-Associated Diarrhea. J. Clin. Microbiol. 41: 3413-3414 [Abstract] [Full Text]  
• Ackermann, G., Degner, A., Cohen, S. H., Silva, J. Jr, Rodloff, A. C. (2003). Prevalence and association of macrolide-lincosamide- streptogramin B (MLSB) resistance with resistance to moxifloxacin in Clostridium difficile. J Antimicrob Chemother 51: 599-603 [Abstract] [Full Text]  
• Wilkins, T. D., Lyerly, D. M. (2003). Clostridium difficile Testing: after 20 Years, Still Challenging. J. Clin. Microbiol. 41: 531-534 [Full Text]  
• Ackermann, G., Tang, Y. J., Kueper, R., Heisig, P., Rodloff, A. C., Silva, J. Jr., Cohen, S. H. (2001). Resistance to Moxifloxacin in Toxigenic Clostridium difficile Isolates Is Associated with Mutations in gyrA. Antimicrob. Agents Chemother. 45: 2348-2353 [Abstract] [Full Text]  
• SPIGAGLIA, P., CARDINES, R., ROSSI, S., MENOZZI, M.G., MASTRANTONIO, P. (2001). Molecular typing and long-term comparison of Clostridium difficile strains by pulsed-field gel electrophoresis and PCR-ribotyping. J Med Microbiol 50: 407-414 [Abstract] [Full Text]  
• McVay, C. S., Rolfe, R. D. (2000). In Vitro and In Vivo Activities of Nitazoxanide against Clostridium difficile. Antimicrob. Agents Chemother. 44: 2254-2258 [Abstract] [Full Text]  
• Titov, L., Lebedkova, N., Shabanov, A., Tang, Y. J., Cohen, S. H., Silva, J. Jr. (2000). Isolation and Molecular Characterization of Clostridium difficile Strains from Patients and the Hospital Environment in Belarus. J. Clin. Microbiol. 38: 1200-1202 [Abstract] [Full Text]  
• Kyne, L., Warny, M., Qamar, A., Kelly, C. P. (2000). Asymptomatic Carriage of Clostridium difficile and Serum Levels of IgG Antibody against Toxin A. NEJM 342: 390-397 [Abstract] [Full Text]  
• Gravet, A., Rondeau, M., Harf-Monteil, C., Grunenberger, F., Monteil, H., Scheftel, J.-M., Prévost, G. (1999). Predominant Staphylococcus aureus Isolated from Antibiotic-Associated Diarrhea Is Clinically Relevant and Produces Enterotoxin A and the Bicomponent Toxin LukE-LukD. J. Clin. Microbiol. 37: 4012-4019 [Abstract] [Full Text]  
• Rafferty, M. E., Baltch, A. L., Smith, R. P., Bopp, L. H., Rheal, C., Tenover, F. C., Killgore, G. E., Lyerly, D. M., Wilkins, T. D., Schoonmaker, D. J., Hannett, G. E., Shayegani, M. (1998). Comparison of Restriction Enzyme Analysis, Arbitrarily Primed PCR, and Protein Profile Analysis Typing for Epidemiologic Investigation of an Ongoing Clostridium difficile Outbreak. J. Clin. Microbiol. 36: 2957-2963 [Abstract] [Full Text]  
• Lyerly, D., Neville, L., Evans, D., Fill, J, Allen, S, Greene, W, Sautter, R, Hnatuck, P, Torpey, D., Schwalbe, R (1998). Multicenter evaluation of the Clostridium difficile TOX A/B TEST [In Process Citation]. J. Clin. Microbiol. 36: 184-190 [Abstract] [Full Text]  
• Chiesa, C., Gianfrilli, P., Occhionero, M., Luzzi, I., Multari, G., Werner, B., Pacifico, L., Midulla, M. (1985). Clostridium difficile Isolation in Leukemic Children on Maintenance Cancer Chemotherapy: A Preliminary Study. CLIN PEDIATR 24: 252-255 [Abstract]