Testing for Clostridium difficile should be restricted to certain stool samples. Indiscriminate testing can result in misleading results.
Clostridium difficile:
(1) can be present as fecal flora
(2) can be present without disease (depending on strain characteristics and host conditions)
A stool submitted for Clostridium difficile testing can be rejected if:
(1) it is formed (not very soft or liquid)
(2) the patient is asymptomatic
(3) there is a previous result AND the sample is submitted during the same clinical episode
(4) testing is being done to confirm cure
(5) the type of specimen is unacceptable of if the specimen has not been properly handled
Exemptions requiring physician request:
(1) Ileus is suspected (may not be associated with diarrhea).
(2) The physician suspects that an initial specimen may have been suboptimal or that a false negative occurred.
The laboratory may chose to reject a specimen collected at colonoscopy since the sample may be suboptimal (a negative result may be a false negative). The gastroenterologist collecting the specimen should be contacted to confirm the request.
Other exemptions:
(1) The stool is being tested as part of an epidemiologic or research study.
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