Clostridium difficile: clinical disease and diagnosis.

Characteristics of Clostridium difficile strains isolated from asymptomatic individuals and from diarrheal patients

“…Five to 70 per cent of healthy infants have C. difficile in their feces, but few of them develop the disease [1,2]. No one knows why infants are protected, but there are a number of hypotheses, including colostrum-containing substances which neutralise toxins A and B [10], the immature nature of the intestinal flora, and the lack of the toxin receptors in the intestine [5].…”

“…Clostridium difficile is a spore-forming anaerobic bacterium. It has been recognised as a major cause of pseudomembranous colitis, antibiotic-associated diarrhea, antibiotic-associated colitis, and non-antibiotic-associated diarrhea [1][2][3][4]. This bacterium produces at least two exotoxins: toxin A, an enterotoxin, and toxin B, a potent cytotoxin.…”

How to detect Clostridium difficile variant strains in a routine laboratory

“…It has long been accepted that toxigenic strains always produce both toxins A and B and that non-toxigenic strains do not posses toxin genes [4]. However, toxin A-negative, toxin B-positive (A-/Bþ) strains have only been described recently [5][6][7].…”

Enteric Infectious Disease in Neonates

“…Clostridium difficile produces at least two potent toxins: toxin A (enterotoxin), which is responsible for pathologic reactivity in the intestines, and toxin B, which is responsible for cytotoxic changes in tissue culture cells. 62 Although no evidence of bacterial invasion of intestinal mucosa exists, C. difficile toxin can cause inflammatory changes in the lamina propria, and pseudomembranous colitis in severe cases. Toxin-producing C. difficile often colonizes in neonates without evidence of disease.…”