Comparing Immunocard with Two EIA Assays for Clostridium Difficile Toxins (Research AND REPORTS‪)‬

INTRODUCTION Clostridium difficile, a spore forming Gram-positive anaerobic bacterium, is the major causative agent of colitis and diarrhea that may occur following antibiotic therapy (1). C. difficile is acquired primarily in hospitals and chronic care facilities and represents one of the most common worldwide nosocomial infections (2). The organism can be cultured from bed rails, toilets and the floors of the rooms of the patients suffering with C. difficile-associated diarrhea, as well as from the hands of health care workers caring for the patients (3). Almost all the patients have been treated with antibiotics or chemotherapy within eight weeks prior to the onset of diarrhea. Many antibiotics have been implicated in this process; clindamycin and third generation cephalosporins are the leading antibiotics in most cases (4). It is postulated that the administration of broad-spectrum antibiotics causes the disruption of normal gut flora, after which colonization with C difficile occurs by ingestion of spores from contaminated objects. Depending on the host's immune status, patients may become asymptomatic carriers or develop diarrhea or pseudomembranous colitis (5). C difficile also causes outbreaks of intestinal disease in hospitalized patients. One study documented 176 C difficile outbreaks in England and Wales during 1992 to 2000, 12.6% of the total infections (6).