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Related Experiment Video

Updated: Mar 26, 2026

Culturing and Maintaining Clostridium difficile in an Anaerobic Environment
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Does Alkaline Colonic pH Predispose to Clostridium difficile Infection?

Purba Gupta1, Stanley Yakubov1, Kevin Tin1

  • 1From the Department of Internal Medicine and the Division of Infectious Diseases, Maimonides Medical Center, Brooklyn, New York.

Southern Medical Journal
|February 4, 2016
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Summary

Alkaline colonic pH is strongly associated with Clostridium difficile infection. This study found that patients with C. difficile infection were more likely to have an alkaline stool pH, suggesting a link between gut environment and infection risk.

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Area of Science:

  • Gastroenterology
  • Infectious Diseases
  • Microbiology

Background:

  • Clostridium difficile causes significant morbidity and mortality, with nearly 500,000 infections and 29,000 deaths reported in 2011.
  • C. difficile is a bacterium responsible for diarrhea and severe illness in healthcare and community settings.
  • The role of colonic pH in C. difficile colonization and infection requires further investigation.

Purpose of the Study:

  • To determine if an alkaline colonic pH predisposes individuals to C. difficile colonization and infection.
  • To investigate the association between stool pH and C. difficile infection status.

Main Methods:

  • A cohort of 228 patients presenting with diarrhea, abdominal pain, leukocytosis, and fever were analyzed.
  • Stool samples were tested for C. difficile antigen and toxin, and stool pH was measured.
  • Statistical analysis was performed to assess the relationship between stool pH and C. difficile infection.

Main Results:

  • 13.2% of patients tested positive for C. difficile infection (antigen+/toxin+).
  • A significantly higher proportion of patients with C. difficile infection (86.7%) had an alkaline stool pH (>7.0) compared to those without (P = 0.002).
  • Patients with a stool pH ≤7.0 had a 96% negative rate for C. difficile infection (P = 0.002).

Conclusions:

  • A strong association exists between C. difficile infection and an alkaline stool pH.
  • Alkaline colonic pH may be a predisposing factor for C. difficile infection.
  • Maintaining a non-alkaline colonic environment could be a strategy to reduce C. difficile infection risk.