4
Figure 1. CDI Laboratory Test Recommendations Based on
Pre-Agreed Institutional Criteria for Patient Stool Submission
Clinicians and laboratory
personnel agree at the
institutional level not to
submit stool specimens
from patients receiving
laxatives and to submit
stool specimens only from
patients with unexplained
and new onset ≥3 unformed
stools in 24 h for testing
for CDI.
Stool toxin test
a
as
part of a multiple step
algorithm (i.e., GDH plus
toxin; GDH plus toxin,
arbitrated by NAAT;
or NAAT plus toxin)
rather than a nucleic
acid amplification test
(NAAT) alone.
a
Approved stool enzyme immunoassay (EIA) toxin tests vary widely in sensitivity.
Laboratories should choose a toxin test with sensitivity in the upper range of
sensitivity as reported in the literature.
NAAT alone OR stool
toxin test
a
as part of a
multiple step algorithm
(i.e. GDH plus toxin;
GDH plus toxin,
arbitrated by NAAT; or
NAAT plus toxin) rather
than a toxin test alone.
YES
NO
Diagnosis
