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Journal of Clinical Microbiology, February 2009, p. 397-400, Vol. 47, No. 2
0095-1137/09/$08.00+0     doi:10.1128/JCM.01591-08
Copyright © 2009, American Society for Microbiology. All Rights Reserved.

Effective and Reduced-Cost Modified Selective Medium for Isolation of Clostridium difficile{triangledown}

Michelle M. Nerandzic1 and Curtis J. Donskey1,2*

Research Service,1 Geriatric Research, Education and Clinical Center, Louis Stokes Cleveland Veterans Affairs Medical Center, Cleveland, Ohio2

Received 16 August 2008/ Returned for modification 26 September 2008/ Accepted 3 December 2008

Both for epidemiologic studies and for diagnostic testing, there is a need for effective, economical, and readily available selective media for the culture of Clostridium difficile. We have developed a reduced-cost substitute for cycloserine-cefoxitin-fructose agar (CCFA), which is an effective but expensive selective medium for C. difficile. The modified medium, called C. difficile brucella agar (CDBA), includes an enriched brucella base as a substitute for proteose peptone no. 2, and the concentration of sodium taurocholate has been reduced from 0.1% to 0.05%. To compare the sensitivities and selectivities of CDBA and CCFA, cultures for C. difficile were performed using stool samples from patients with C. difficile-associated disease. CDBA was as sensitive as CCFA for the recovery of C. difficile, with a similar frequency of breakthrough growth of stool microflora (25% versus 31%, respectively). A liquid formulation of the modified medium, termed C. difficile brucella broth (CDBB), stimulated rapid germination and outgrowth of C. difficile spores, at a rate comparable to that in cycloserine-cefoxitin-fructose broth. Our results suggest that CDBA and CDBB are sensitive, selective, and reduced-cost media for the recovery of C. difficile from stool samples.

* Corresponding author. Mailing address: Research Service, Louis Stokes Cleveland Veterans Affairs Medical Center, 10701 East Blvd., Cleveland, OH 44106. Phone: (216) 791-3800, ext. 5103. Fax: (216) 229-8509. E-mail: curtisd123{at}yahoo.com

{triangledown} Published ahead of print on 10 December 2008.

Journal of Clinical Microbiology, February 2009, p. 397-400, Vol. 47, No. 2
0095-1137/09/$08.00+0     doi:10.1128/JCM.01591-08
Copyright © 2009, American Society for Microbiology. All Rights Reserved.



This article has been cited by other articles:

  • Nerandzic, M. M., Pultz, M. J., Donskey, C. J. (2009). Examination of Potential Mechanisms To Explain the Association between Proton Pump Inhibitors and Clostridium difficile Infection. Antimicrob. Agents Chemother. 53: 4133-4137 [Abstract] [Full Text]  
  • Bloedt, K., Riecker, M., Poppert, S., Wellinghausen, N. (2009). Evaluation of new selective culture media and a rapid fluorescence in situ hybridization assay for identification of Clostridium difficile from stool samples. J Med Microbiol 58: 874-877 [Abstract] [Full Text]  


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