Antibiotic Associated Diarrhoea and Colitis: The role of by S. P. Borriello (auth.), S. Peter Borriello PhD. (eds.)

By S. P. Borriello (auth.), S. Peter Borriello PhD. (eds.)

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Extra info for Antibiotic Associated Diarrhoea and Colitis: The role of Clostridium difficile in gastrointestinal disorders

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Ten samples (12%) yielded C. difficile on CCA only, and five specimens (6%) only by the alcohol procedure. In most cases quantitative recovery was greater on the selective agar. Both of these spore selection techniques use the ability of clostridial species to form endospores. The formation and germation of a bacterial spore is complex and can be affected by various manipulations. Ionesco (1978) has shown that spore germination maybe initiated by lysozyme and that treatment of the spores with the reducing agent sodium thioglycollate in the presence of lysozyme at a concentration of 5 IIg/ml allows for the germination of 'superdormant' spores.

1978, Borriello, 1979). , 1978). In this method an aliquot of a low dilution of the material to be examined is mixed with an equal volume of absolute ethanol and left at room temperature for one hour before any further diluting and plating onto agar media. This method has been fully evaluated by Borriello and Honour (1981) and shown to be a very effective way of isolating ~. difficile. Of 266 faecal samples analysed 82 were shown to be positive for ~. difficile by a combination of the use of a cycloserine-cefoxitin selective agar (CCA) and alcohol spore selection.

1980, see also section on identification). Table 1 Fluorescent labelled antibody for the detection of Clostridium Difficile in stool specimens Fluorescent labelled antibody Clostridium difficile/toxin A Positive Negative 26 6 Positive B 3 1 C A 4 5 121 1 Negative B C 7 21 8 13 Legend - A antibiotic associated diarrhoea. Diarrhoea unrelated to antibiotics Healthy adults Figure compiled from the data of Wilson et al 1982b. , (1981) and shown to be effective for detecting ~. difficile in the caecal contents of hamsters, and when used to estimate the number of bacteria present consistently gave higher values than those estimated by direct counts on a selective medium.

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