Clostridium difficile. Colonization and toxin production in a cohort of patients with malignant hematologic disorders

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Abstract
Of 56 consecutive adult patients with malignant hematologic disorders who were hospitalized during a 15 wk period at Emory University Hospital, Atlanta [Georgia, USA], 45 (80%) were examined. Stool samples for C. difficile culture and cytotoxin assay were obtained on admission and then weekly during each patient''s hospitalization. On admission, 4 patients had detectable C. difficile in their stool samples, which was associated with prior antimicrobial use but not with prior cancer chemotherapy. One of the 4 patients with positive stool samples also had toxin present in the stool sample and was the only one with diarrhea. Of 22 patients hospitalized for .gtoreq. 1 wk, 8 (36%) had C. difficile isolated from at least 1 stool specimen. The positive cultures showed no clustering in time; no risk factors were identified for colonization. Seven of 15 culture-positive stool samples and 3 of 7 toxin-positive samples were associated with diarrhea.

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