Patients with new-onset diarrhea without an alternative explanation should be considered for CDI testing. Diarrhea is defined as ≥3 unformed stools in 24 hours.
Per Michigan Medicine C. difficile Infection Guidelines, testing is rarely indicated or recommended for infants less than 12 months and will be rejected. Approval from Pediatric Infectious Disease is required to perform testing on patients less than 12 months of age.
There is no role for performing both GIPAN and PCRCD simultaneously or performing a PCRCD after a GIPAN as the tests results for C. difficile are essentially the same.
PCRCD may remain positive for up to 30 days after successful treatment; tests of cure should not be performed.
Results within 2-6 hours of receipt in lab
- Antibiotic Associated Colitis (AAC)
- Colitis, Clostridium difficile
- Pseudomembranous Colitis Toxin Assay
- CLOST. DIFFICILE TOXIN B, PCR
- Clostridium difficile Antigen
- Clostridium difficile Toxin
- CLOSTRIDIUM DIFFICILE TOXIN
- CLOSTRIDIUM DIFFICILE
- GDH Screen
- GDH Antigen
Collect at least 5 mL of fresh stool and place in a sterile screw-capped container with no preservative. Formed stools are not acceptable. Refrigerate and send specimen immediately after collection. Specimen must be received within 24 hours of collection. Collect no more than one specimen in a 7-day period. See MLabs Stool Specimen Collection Instructions available online at https://mlabs.umich.edu/media/175 for patient instructions.
Formed stools are not acceptable. (Exceptions made for BMT patients where indicated)
Specimen received >24 hours following collection.
Repeat C difficile testing within 7 days of a negative C. difficile test or within 14 days of a positive C. difficile test is not acceptable.
Stool in preservative, such as Cary Blair (Stool C&S transport), is not acceptable.
Testing ordered on patients ≤1 year old is not acceptable.
If a CDIFF test must be cancelled after being received by the laboratory, laboratory staff will contact the care team via alpha page to notify them that the test will be cancelled.
If PCR for toxigenic C. difficile is positive, confirmation testing for C. difficile Toxin A/B by EIA will be performed at an additional charge. By ordering this test the clinician acknowledges that additional reflex testing will be performed and billed at a separate additional charge if indicated.