[Isolation of Clostridium difficile from the stools of hospitalized patients with diarrhea]

408 stool samples from 354 hospitalized patients with diarrhea were evaluated for the presence of Clostridium difficile. C. difficile was detected in stools of 42 patients (12%), 19 of them being hospitalized in neurosurgery units. The strains were cytotoxigenic in 31 cases and non cototoxigenic in 11 cases. The diagnosis of C. difficile induced diarrhea was based on the clinical setting [presence of diarrhea that could be attributed to antimicrobial therapy and endoscopy for detection of pseudomembranous colitis (PMC)], laboratory studies (cytotoxigenic strains of C. difficile) and therapeutic response (oral vancomycin or metronidazole). C. difficile was implicated as a cause of PMC (2 cases) and antimicrobial associated diarrhea (8 cases) (PMC not documented). The pathogenic role of C. difficile was questionable in 24 cases (no specific therapy) and unlikely in 8 cases. In fact C. difficile could be implicated as a cause of diarrhea in 24% of the cases.