Clostridium difficile - toxins-screening by PCR
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CLOBM
Synonyms
- Presumed diagnosis of O27 types of Clostridium difficile
- Search for B and binary toxins of C. difficile.
Specialty
Infectious
Clinical significance
Toxigenic strains of Clostridium difficile are responsible for post-antibiotic diarrhea, nosocomial diarrhea and, in most severe forms, pseudomembranous colitis that can lead to toxigenic shock.Toxigenic C. difficile strains carry genes that encode toxins that play a major role in strain's virulence: toxin A (or enterotoxin), and toxin B (or cytotoxin). Toxins A and B are produced simultaneously but about 3% of toxigenic strains do not produce toxin A. Strains producing only toxin A have also recently been described. Some toxigenic C. difficile strains can also synthesize a binary toxin (cdtA and cdtB genes).The Xpert® Clostridium difficile test has several targets: the toxin B gene (tcdB), the binary toxin gene (cdtA), and the deletion in the tcdC gene at base 117 associated with ribotype 027 (presumptive diagnosis of the so-called 027 toxigenic strain isolated in some French health care institutions since 2005).In the context of a clinical suspicion of C. difficile infection, a search for GDH +/- free toxins is indicated in first instance. When the GDH test is positive but the free toxins are negative, toxin genes can be tested by PCR as a second-line test.The diagnosis of C. difficile infection is made in the context of diarrhea, in patients over 3 years old.
Further information
Enclose the specific request form B18 : Bacteriology-Parasitology-Mycology
The use of the S14UK transport bag is Mandatory.
Specific equipment available
- S14: Special mycobacteria transport bags are to be used
Documents to download
Methodology
Molecular biology
Turnaround time
1 day
