Clostridium difficile Culture with Reflex to Cytotoxin Cell Assay

Casandra

Casandra Test Code AR84537Version 1 (DRAFT)

Performing Lab

Lab ARUP LaboratoriesLab Test ID 0060140CPT Codes 87075, 87230

Clostridium difficile Culture with Reflex to Cytotoxin Cell Assay

Also known as: MC CDIF

Clinical Use

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Use

This test serves as a reference method for the diagnosis of Clostridioides (Clostridium) difficile-associated diarrhea. It provides culture identification of Clostridium difficile, followed by a cytotoxin cell assay if the culture result is positive. Although not the initial recommended test, it serves as a confirmatory method with a turnaround time of four days for negative results and sooner for positive identification. Culture methods can help identify the presence of the organism, which may not always produce toxin, thereby assisting in diagnosing antibiotic-associated colitis and healthcare-associated diarrhea.

Special Instructions

The preferred initial test for Clostridium difficile-associated diarrhea is Clostridium difficile toxin B gene (tcdB) by PCR, ARUP test code 2002838. If a culture is positive, a cytotoxin cell assay will be reflexed, incurring additional charges. The test requires specific specimen collection methods and transportation conditions to ensure accurate results.

Limitations

Culture methods have limitations, including longer turnaround times compared to PCR methods, and the possibility of detecting organisms that may not produce toxins (therefore not causing disease). This test should not be used as a standalone diagnostic tool but in conjunction with clinical findings and other diagnostic tests such as toxin gene PCR assays. Formed stools and improperly collected or stored specimens (e.g., placed in formalin) are unacceptable and may lead to rejection.

Test Details

New York Approved