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Test Code CDIF Clostridioides difficile Culture, Varies

Useful For

Providing an isolate suitable for antimicrobial susceptibility testing

Reflex Tests

Test ID Reporting Name Available Separately Always Performed
ANAID Anaerobe Ident No, (Bill Only) No
RMALA Id MALDI-TOF Mass Spec Anaerobe No, (Bill Only) No
ISAN Anaerobe Ident by Sequencing No, (Bill Only) No

Testing Algorithm

When this test is ordered, the reflex tests may be performed at an additional charge.

Reporting Name

C. difficile Culture

Specimen Type

Varies


Ordering Guidance


If susceptibilities are also desired, order CDIFS / Clostridioides (Clostridium) difficile Culture with Antimicrobial Susceptibilities, Varies

 

This is not the preferred diagnostic test for Clostridioides difficile. For routine diagnostic testing, order CDPCR / Clostridioides difficile Toxin, PCR, Feces.



Additional Testing Requirements


If susceptibility testing is needed; also order MMLSA / Antimicrobial Susceptibility, Anaerobic Bacteria, MIC, Varies. Susceptibility testing, when ordered, would routinely include metronidazole and vancomycin. If susceptibilities are not appropriate and will not be performed, MMLSA will be canceled.



Shipping Instructions


 



Necessary Information


Specimen source is required.



Specimen Required


Submit only 1 of the following specimens:

 

Patient Preparation: Patient should not use antacids, barium, bismuth, antidiarrheal medication, zinc oxide paste, Vagisil cream or oily laxatives prior to specimen collection.

 

Preferred:

Specimen Type: Preserved feces

Supplies: Culture and Sensitivity Stool Transport Vial (T058)

Container/Tube: Commercially available transport system specific for recovery of enteric pathogens from fecal specimens (15 mL of non-nutritive transport medium containing phenol red as a pH indicator, either Cary-Blair or Para-Pak C and S)

Specimen Volume: Representative portion of feces; 5 mL

Collection Instructions:

1. Collect 1 gram or 5 mL fresh fecal specimen and submit in container with transport medium.

2. Place feces in preservative within 2 hours of collection.

Additional Information: Only diarrheal (ie, unformed) feces should be tested. Testing formed feces for Clostridioides difficile is generally not clinically indicated.

Specimen Stability Information: Ambient (preferred) 96 hours/Refrigerated 96 hours/Frozen 7 days

 

Acceptable:

Specimen Type: Unpreserved feces

Supplies:

-Stool container, Small (Random), 4 oz (T288)

-Stool Collection Kit, Random (T635)

Container/Tube: Stool container

Specimen Volume: Representative portion of feces

Collection Instructions: Collect fresh feces and submit representative sample in stool container.

Additional Information: Only diarrheal (ie, unformed) feces should be tested. Testing formed feces for Clostridioides difficile is generally not clinically indicated.

Specimen Stability Information: Ambient (preferred) 72 hours/Frozen 7 days

 

Specimen Type: Fresh tissue or biopsy

Sources: Colon

Supplies: Anaerobe Transport Tube (T588)

Specimen Volume: Entire collection, 1 to 2 cm(3)

Collection Instructions: Aseptically collect 1 to 2 cm(3) piece of tissue whenever possible. In general, a larger piece of tissue is preferred. Submit in an anaerobic transport tube.

Specimen Stability Information: Ambient 72 hours


Specimen Minimum Volume

Stool: 1 g or 5 mL
Tissue: 5 mm(3)

Specimen Stability Information

Specimen Type Temperature Time Special Container
Varies Varies

Reject Due To

Fecal swab
Specimen in Ecofix
Reject

Reference Values

No growth of Clostridioides difficile.

Supportive Data

Fifty fecal specimens in Cary Blair transport media previously determined as positive for Clostridioides difficile by toxin polymerase chain reaction were subcultured directly onto CHROMagar C difficile plates. Plates were incubated under anaerobic conditions at 37° C for 24 hours in accordance with the manufacturer's recommendation. C difficile identification was performed by matrix assisted laser desorption ionization time-of-flight mass spectrometry (MALDI-TOF MS) directly from bacterial colony growth on CHROMagar plates. Using this method, C difficile was identified from 47 of 50 fecal specimens, corresponding with a 94% recovery rate. Two specimens that did not yield C difficile on CHROMagar media also failed to produce growth on conventional C difficile selective media (taurochocolate, cycloserine, cefoxitin, fructose agar: TCCFA). One specimen was recovered by the TCCFA media, but not by the CHROMagar C difficile media. Organisms other than C difficile were not recovered on CHROMagar, corresponding to 100% analytical specificity.

Day(s) Performed

Monday through Sunday

Report Available

2 to 6 days

Specimen Retention Time

7 days

Performing Laboratory

Mayo Clinic Laboratories in Rochester

CPT Code Information

87081-C. difficile Culture

87076-Anaerobe Ident (if appropriate)

87076-Id MALDI-TOF Mass Spec Anaerobe (if appropriate)

87153-Anaerobe Ident by Sequencing (if appropriate)

LOINC Code Information

Test ID Test Order Name Order LOINC Value
CDIF C. difficile Culture 562-9

 

Result ID Test Result Name Result LOINC Value
CDIF C. difficile Culture 562-9

Forms

If not ordering electronically, complete, print, and send a Gastroenterology and Hepatology Test Request (T728) with the specimen.