J Clin Pathol 1981;34:1124-1127 Simplified procedure for the routine isolation of Clostridium dificile from faeces

SUMMARY The use of alcohol, at a final concentration of 50%, as a selective procedure for the isolation of Clostridium difficile was compared to a selective medium containing 250 pig/ml of cycloserine and 10,ug/ml of cefoxitin. Of 266 faecal samples 82 were shown to be positive by one or other method. Seventy-seven (94%) of these were detected by the selective agar (SA) and 72 (88%) by the alcohol procedure (AP). Ten samples (12%) were positive only by SA and five samples (6°,) by AP only. The AP was further modified so that all manipulations prior to incubation were per-formed on the open bench. Of 18 positive samples, 18 (100%) were detected by SA and 16 (89%/) by AP. There has been an increasing body of evidence generated during the last few years which firmly implicates Clostridium difficile as the aetiological agent of both antibiotic and non-antibiotic associ-ated pseudomembranous colitis (PMC).1-4 There is also recent evidence to implicate this micro-organism in diarrhoea unrelated to PMC,4 and as