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Microbiology · Bacteriology: Clostridioides difficile
Sample itemWatery diarrhoea and pseudomembranes develop after clindamycin treatment. Which test best supports infection by toxigenic Clostridioides difficile?
Original practice item, not a recalled exam question. Nothing here is recorded.
The answer and the reasoning
B. Detection of toxin genes or toxin in unformed stool
C. difficile diagnosis is made in symptomatic patients using an assay for toxigenic organisms or toxin on unformed stool. Colonisation is common, so testing formed stool or asymptomatic patients can mislead.
Option by option
A. Urease testing of stool
Urease testing is not used for C. difficile diagnosis.
B. Detection of toxin genes or toxin in unformed stool (correct)
Correct. The clinically relevant diagnosis is toxin-producing C. difficile in diarrhoeal stool.
C. Serum antistreptolysin O titre
ASO indicates recent streptococcal exposure.
D. Culture of a formed stool sample alone
Culture alone does not establish toxin production or disease.
Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.
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