| DESCRIPTION |
Clostridium difficile is a species of gram-positive bacteria. The disease
presence of Clostridium difficile.
Laboratory services are quite varied as to how they identify the presence
of Clostridium difficile. Some labs are set up to identify C. difficile as
the final microbiological (bacterial) etiology of a culture, even if a
culture method was not used. Other labs use a final etiology of "see
comment" and then enter the results in a free text format. Still others
enter the text under a hematology or chemistry format where a reference
range and "positive" and "negative" result values can be entered.
Wherever the VHA Laboratory Service places the results, which are used to
is associated with the presence of Clostridium difficile enterotoxin,
demonstrate the presence of toxin-producing C. difficile, should be
accessible as a standardized field in order to allow the MDRO Programs
Tool software to capture its presence.
NOTE: The purpose of adding Clostridium difficile to the MDRO Tools Lab
Parameter Setup is to identify a patient's current or prior history of
Clostridium difficile based on laboratory reporting and the time frames
that are entered to search for the patient's status. The result must
occur as a Clostridium difficile (a bacterial etiology) or as a
retrievable "positive" result for a chemistry/serology laboratory test.
which can cause significant morbidity, as well as mortality. It is of
Any results contained in a "Free-Text" section will not allow
incorporation of Clostridium difficile into the MDRO Program Tools
software CDI Report format. Refer to the "VistA Lab Enhancements (VLE) -
Microbiology User Guide" for instructions to configure the MDRO Tools Lab
Parameter Setup to properly run the CDI Report.
importance, as its predominant acquisition appears to occur nosocomially
and is the most serious cause of antibiotic-associated diarrhea. Presence
of clostridial toxin (either enterotoxin or cytotoxin L) by assay (whether
it be EIA, latex agglutination, cytotoxicity of cell culture
+neutralization, or culture of organism with subsequent colony testing) is
the best indicator that an inflammatory diarrheal disease is due to
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