4059. Clostridium difficile (toxin A/B), fecal antigen (qualitative determination)

C. difficile colonizes the large intestine in humans. The ability of C. difficile to cause intestinal inflammation is based on two factors: high colonization capacity and the patient's immune response to the antigen. The large intestine is protected by a native flora of 4,000 species of bacteria, which together provide resistance to colonization by pathogenic species by competing for essential nutrients and attachment sites to the intestinal wall.

Antibiotics disrupt the barrier microflora and reduce protection against colonization by pathogenic microorganisms. There are both toxigenic and non-toxic strains, but only toxigenic C. difficile causes disease in humans.

Pathogenicity depends on the presence of one or two diarrhea-causing toxins: toxin A and toxin B. All toxigenic strains contain toxin B, with or without toxin A. Both toxins lead to the death of intestinal cells, stimulate an inflammatory response that exacerbates tissue damage, causes diarrhea and pseudomembranous colitis. There is also a third one, a binary toxin that increases the virulence of C. difficile.

Recommended for suspected pseudomembranous colitis in patients at high risk:

• age over 65 years, prolonged hospitalization (especially stay in the ICU), surgery, the presence of malignant tumors, renal failure, inflammatory diseases of the colon, chemotherapy, taking proton pump inhibitors, hypoalbuminemia, enteral nutrition, intestinal ischemia;
• hospital patients with diarrhea after antibiotic therapy.

• Stool