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More on Clostridium difficile-associated diarrhoea in Australia

Chen, F., Chakera, A., Seow, C., Ling, K., Plant, A.J. and Riley, T.V. (1999) More on Clostridium difficile-associated diarrhoea in Australia. Anaerobe, 5 (3-4). pp. 205-207.

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To evaluate further the importance of Clostridium difficile as a cause of diarrhoea in Australia, 165 hospital laboratories were surveyed about 1995 using a self-administered questionnaire. Only 91 (55%) laboratories responded and only 39 of these (43%) had laboratory facilities to detect C. difficile routinely, 13 (33%) on request only and 19 (49%) on request or in certain situations. Culture was used by 26 laboratories (67%), 15 (36%) used tissue culture assays and 24 (62%) used commercially available toxin kits. C. difficile detection rates varied from < 1 to 49 per 100 hospital beds. Isolation rates in some small hospitals (< 100 beds) were surprisingly high (15 cases per 100 beds) indicating that C. difficile-associated diarrhoea is not just confined to large institutions. Hospital laboratories using culture and tissue culture cytotoxin assays had higher detection rates than laboratories relying only on toxin detection kits. Detection rates were correlated with antimicrobial usage figures for those hospitals which could provide usage data and with laboratories considered competent in detecting C. difficile. The correlation between incidence of C. difficile-associated diarrhoea and third generation cephalosporin usage was 0.87, while for gentamicin this figure was 0.37. The importance of C. difficile as a nosocomial pathogen is still generally underestimated in Australia. Significant diagnostic and financial benefits may follow improvements in detection techniques and restrictions in third generation cephalosporin usage.

Item Type: Journal Article
Publisher: Academic Press Inc.
Copyright: © 1999 Academic Press
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