Clostridium difficile Pathway

Overview

  • EPIC Code:
  • LAB3208
  • Soft Test Code:
  • CDMT
Alternate Names
  • C diff
  • C Diff Pathway
  • C-Diff Pathway
  • C. diff Toxin
  • C. DIFFICILE MOLECULAR W/ TOXIN EIA REFLEX
  • cdiff
  • CDiff Pathway
  • Clostridum difficile
  • GDH
  • Toxins
Clinical Significance

Clostridium difficile infection is a serious disease causing diarrhea, colitis, and even pseudomembranous colitis that develops as a result of antibiotic treatment. It may also occur due to nosocomial transmission. Recently, community acquired infections have been found with patients who have not received antibiotics. It is important that true cases be identified quickly to allow treatment which will prevent serious sequelae for the patient and possible nosocomial transmission.


Specimen Collection & Preparation

Test Notes

No "test of cure" specimens should be submitted.  Patients may remain positive for long periods without symptoms.


Patient Preparation

Patients must be symptomatic. 


Specimen Requirements:

-OR-

5.0 mL unformed Feces in a Non-Sterile Yellow Capped Container
Specimen Information:

Only specimens that conform to the container shape will be tested.


Rejection Criteria:

Procedural stools (colostomy specimens, ileostomy specimens, etc.)

Formed stools

Specimens received within 10 days of a positive result

Received within 7 days of a previous negative result


Transport and Storage:
  • Refrigerated (2-8°C): ≤72 Hours
  • Frozen (-20° C or colder): >72 Hours

Clinical Interpretation

Reference Range:

Negative for toxigenic Clostridium difficile by DNA amplification. Positive for toxigenic Clostridium difficile by DNA amplification.
Negative for Toxins A & B by EIA. Positive for Toxins A & B by EIA.


Test Comments:

Molecular testing (for the tcdB Toxin B gene of toxigenic Clostridium difficile) is performed initially to determine presence of organism genome. Only a positive molecular test will reflex EIA testing for Toxins A & B


Methodology:
  • Molecular PCR, Toxin EIA
Clinical Significance

Clostridium difficile infection is a serious disease causing diarrhea, colitis, and even pseudomembranous colitis that develops as a result of antibiotic treatment. It may also occur due to nosocomial transmission. Recently, community acquired infections have been found with patients who have not received antibiotics. It is important that true cases be identified quickly to allow treatment which will prevent serious sequelae for the patient and possible nosocomial transmission.


Production Schedule

Sites Performed
  • Parkview Regional Medical Center
Days Performed
Sunday
Monday
Tuesday
Wednesday
Thursday
Friday
Saturday
Departments
  • Microbiology
Turn Around Time

8 to 12 hours


Coding & Compliance

CDM

01425522


CPT Coding

87493, Reflex 87324


Medical Necessity Documentation

Testing may only be performed after 7 for original negative, and  after 10 days for original positive