A screen for Clostridium difficile in the vagina: an out-patient study using and comparing selective media

Cycloserine-Cefoxitin-Fructose Agar (CCFA) gives good presumptive identification of Clostridium difficile after 1- or 2-day incubation whereas Reinforced Clostridial Medium (RCM)/p-cresol is not very selective for the organism from the vagina. The identification of 91.5% of the isolates from an initial screen subjected to biochemically based tests was achieved. Conventional screening of vaginal swabs failed to confirm any significant occurrence of Cl. difficile in the vagina of pregnant or non-pregnant women. The incorporation of an enrichment stage in the isolation procedure, however, did reveal a significant presence of the organism in the vagina of both pregnant and non-pregnant women.