Clostridioides (Clostridium) difficile GDH antigen and toxins A and B detection in stool

Clostridium difficile is a rod-shaped anaerobic bacterium (bacilli, bacillus) thatra causes pseudomembranous colitis and is a common cause of post-antibiotic diarrhea. C. difficile also forms heat-resistant spores thatre able to remain in the environment for several months to several years.

C. difficile-associated colitis is caused by a disruption of the normal bacterial flora of the colon and excessive colonization by C. difficile. This microorganism secretes two types of toxins: toxin A and B. Toxin A is an enterotoxin- causes inflammation of the intestinal mucosa increased secretion of fluidinto the intestinal lumen, while toxin B has a cytotoxic effect. Both of these toxins work closely togetherly in the pathogenesis of the disease-in combination they cause inflammation and damage to the intestinal mucosa.

Normal (physiological) intestinal flora protects the colon from other pathogens, but antibiotic treatment inhibits its correct reproduction and disrupts the rbalance, facilitating increased colony growth of C. difficile. Thus, a key risk factor for C. difficile infection is antibiotic therapy, whichra suppresses the normal intestinal flora.

C. difficile-associated colitis is mainly observed in hospitalized, adult and immunocompromised patients. It is symptomatic with diarrhea, whichra can be mild, moderate or severe. It can also lead to the development of pseudomembranous colitis or other fulminant forms of colitis. Severe complications of the severe forms can include acute colonic distension, perforation of the colon or peritonitis.

During C. difficile infection, the most common symptoms are mild to moderate diarrhea, abdominal painl, loss of appetite and fever. In more severe forms, dehydration is expressed to varying degrees. Rarely, pathologic fecal blemishes are present.

In asymptomatic forms of C. difficile infection, there are no clinical signs in the asymptomatic carrier.

Clostridium difficile test

Fecal test for the presence of toxins A and B. C. difficile:

The test should be performed on material collected from stool — 1-2 g of fecal matter or 1-2 ml (for watery diarrhea) stored in a disposable container.

The test should be performed within 3 hours of collecting the material. If this is not possible, the prb should be stored at 2-8 ° C for a maximum of 3 days.

Clostridium difficile – when to perform the test?

Testing for the presence of toxins A and B of the bacterium C. difficile is ordered in cases of diarrhea of varying severity, lasting several days:

• appearing within 2 months after completion of antibiotic therapy
• manifesting 72 hours after starting antibiotic treatment
• in immunocompromised individuals and individualsb undergoing immunosuppressive therapy
• occurring during prolonged hospital stay;

This test is also ordered as a diagnostic to clarify the etiology of diarrhea, along with routine corpocultures for the more common bacterial agents– such as Salmonella, Shigella or Staphylococcus.

Preparing for the test

• No prior preparation for the test is required.

Test material

• Fecal specimen – 1-2 g of fecal matter or 1-2 ml in case of liquid consistency diarrhea, stored in a suitable container