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Test ID CDIFS Clostridioides difficile Culture with Antimicrobial Susceptibilities, Varies


Ordering Guidance


Culture is not the preferred diagnostic test for Clostridioides difficile. For routine diagnostic testing, order CDPCR / Clostridioides difficile Toxin, PCR, Feces



Shipping Instructions


 



Necessary Information


Specimen source is required.



Specimen Required


Submit only 1 of the following specimens:

 

Patient Preparation: Patient should not use antacids, barium, bismuth, antidiarrheal medication, zinc oxide paste, Vagisil cream or oily laxatives prior to specimen collection.

 

Preferred:

Specimen Type: Preserved feces

Supplies: Culture and Sensitivity Stool Transport Vial (T058); Stool Collection Kit, Random (T635)

Container/Tube: Commercially available transport system specific for recovery of enteric pathogens from fecal specimens (15 mL of non-nutritive transport medium containing phenol red as a pH indicator, either Cary-Blair or Para-Pak C and S [T058])

Specimen Volume: Representative portion of feces; 5 mL

Collection Instructions:

1. Collect 1 gram or 5 mL fresh fecal specimen and submit in container with transport medium.

2. Place feces in preservative within 2 hours of collection.

Additional Information: Only diarrheal (ie., unformed) feces should be tested. Testing formed feces for C difficile is not clinically indicated.

Specimen Stability Information: Ambient (preferred) 96 hours/Refrigerated 96 hours/Frozen 7 days

 

Acceptable:

Specimen Type: Unpreserved feces

Supplies: Stool container, Small (Random), 4 oz (T288); Stool Collection Kit, Random (T635)

Specimen Volume: Representative portion of stool

Collection Instructions: Collect fresh stool and submit representative sample in stool container.

Specimen Stability Information: Ambient (preferred) 72 hours/Frozen 7 days

Additional Information: Only diarrheal (i.e., unformed) stool should be tested. Testing formed stool for C difficile is not clinically indicated.

Specimen Stability Information: Ambient (preferred) 72 hours/Frozen 7 days

 

Specimen Type: Fresh tissue or biopsy

Sources: Colon

Supplies: Anaerobe Transport Tube (T588)

Specimen Volume: Entire collection, 1-2 cm(3)

Collection Instructions: Aseptically collect a 1-2 cm(3) piece of tissue whenever possible. In general, a larger piece of tissue is preferred. Submit in an anaerobic transport tube.

Specimen Stability Information: Ambient 72 hours


Useful For

Providing an isolate suitable for antimicrobial susceptibility testing to direct antimicrobial therapy of extraluminal infections and in cases of treatment failure

Highlights

Culture provides definitive evidence of the presence of the bacterium Clostridioides (Clostridium) difficile in feces, providing an isolate for antimicrobial susceptibility testing.

 

Susceptibility testing of C difficile isolates may be warranted in cases of treatment failure, or when used to guide therapy of extraluminal infections.

Reflex Tests

Test ID Reporting Name Available Separately Always Performed
ANAID Anaerobe Ident No, (Bill Only) No
RMALA Id MALDI-TOF Mass Spec Anaerobe No, (Bill Only) No
ISAN Anaerobe Ident by Sequencing No, (Bill Only) No
SANA Anaerobe Suscep per agent No, (Bill Only) No
BATTA Anaerobe Suscep Battery No, (Bill Only) No

Testing Algorithm

When this test is ordered, the reflex tests may be performed and charged separately. Isolates of Clostridioides (Clostridium) difficile (1,2) will automatically have susceptibility testing performed and billed as appropriate. Antimicrobial agents appropriate to the organism and specimen source will be tested according to Mayo’s practice and the laboratory’s standard operating procedures.

 

See Anaerobic Bacteria Antimicrobials in Special Instructions to review the table which provides a listing of the antimicrobials routinely tested in our laboratory as well as antimicrobials that may be tested upon request. If the antimicrobial of interest is not listed in this table, contact Mayo Clinic Laboratories at 800-533-1710 and ask to speak to the Bacteriology Anaerobe Laboratory.

 

Anaerobe susceptibilities battery will routinely be performed at an additional charge. If fewer than 3 antibiotics will be reported, then anaerobe susceptibilities battery will be canceled and anaerobe susceptibilities per agent will be charged per antibiotic tested. Based on susceptibility criteria, anaerobe susceptibilities per agent may be performed at an additional charge.

Special Instructions

Method Name

Conventional Culture Technique with Minimum Inhibitory Concentration (MIC) by Agar Dilution

Reporting Name

C. difficile Culture + Susc

Specimen Type

Varies

Specimen Minimum Volume

Stool: 1 gram or 5 mL
Tissue: 5 mm(3)

Specimen Stability Information

Specimen Type Temperature Time Special Container
Varies Varies

Reference Values

No growth of Clostridioides difficile.

 

Susceptibility results are reported as minimal inhibitory concentration (MIC) in mcg/mL. Breakpoints (also known as clinical breakpoints) are used to categorize an organism as susceptible, susceptible-dose dependent, intermediate, resistant, or nonsusceptible according to breakpoint setting organizations, either the Clinical and Laboratory Standards Institute (CLSI) or the European Committee on Antimicrobial Susceptibility Testing (EUCAST), as applicable.

 

In some instances, an interpretive category cannot be provided based on available data; therefore, the following comment will be included on the report: There are no established interpretive guidelines for agents reported without interpretations.

 

For information regarding CLSI and EUCAST susceptibility interpretations, see Susceptibility Interpretative Category Definitions.

Day(s) Performed

Monday through Sunday

Report Available

2 to 9 days

Performing Laboratory

Mayo Clinic Laboratories in Rochester

Test Classification

This test has been cleared, approved, or is exempt by the US Food and Drug Administration and is used per manufacturer's instructions. Performance characteristics were verified by Mayo Clinic in a manner consistent with CLIA requirements.

CPT Code Information

87081-C. difficile Culture

87076-Anaerobe Ident (if appropriate)

87076-Id MALDI-TOF Mass Spec Anaerobe (if appropriate)

87153-Anaerobe Ident by Sequencing (if appropriate)

87181-Anaerobe Susceptibility per agent (if appropriate)

87181 x 3-Antimicrobial Susceptibility, Anaerobic Bacteria, MIC (if appropriate)

LOINC Code Information

Test ID Test Order Name Order LOINC Value
CDIFS C. difficile Culture + Susc 105047-5

 

Result ID Test Result Name Result LOINC Value
CDIFS C. difficile Culture + Susc 105047-5

NY State Approved

Yes