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Evidence for antibiotic induced Clostridium perfringens diarrhoea

N Modi, M H Wilcox

Department of Microbiology, The General Infirmary and University of Leeds, Old Medical School, Leeds, LS1 3EX, UK

Correspondence to:
Dr Wilcox markwi{at}pathology.leeds.ac.uk

Clostridium difficile is a well documented cause of antibiotic associated diarrhoea in hospitalised patients, but may account for only approximately 20% of all cases. This leader reviews the current knowledge and understanding of the pathogenesis, epidemiology, and diagnosis of non-food borne Clostridium perfringens diarrhoea. Although enterotoxigenic C perfringens has been implicated in some C difficile negative cases of antibiotic associated diarrhoea, C perfringens enterotoxin detection methods are not part of the routine laboratory investigation of such cases. Testing for C perfringens enterotoxin in faecal samples from patients with antibiotic associated diarrhoea and sporadic diarrhoea on a routine basis would have considerable resource implications. Therefore, criteria for initiating investigations and optimum laboratory tests need to be established. In addition, establishing the true burden of C perfringens antibiotic associated diarrhoea is important before optimum control and treatment measures can be defined.

Key Words: Clostridium perfringens • Clostridium difficile • hospital acquired infective diarrhoea

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