Which biomarkers may be useful for distinguishing between Clostridium difficile (C diff) colonization and actual disease?

Updated: Jul 25, 2019
  • Author: Faten N Aberra, MD, MSCE; Chief Editor: BS Anand, MD  more...
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A study by El Feghaly et al indicated that fecal inflammatory cytokines may be useful as biomarkers for distinguishing between C difficile colonization and actual disease. They may also be helpful in determining whether a child with C difficile infection is at a high risk for prolonged diarrhea. The study involved 65 children who were known to be C difficile positive, as well as symptomatic and asymptomatic controls. Results included the following [45] :

  • Fecal cytokines: Elevated in symptomatic children (cases and controls); also elevated at diagnosis in patients with a significantly greater time to resolution of diarrhea (TTROD)

  • Fecal chemokine ligand (CXCL)–5 messenger ribonucleic acid (mRNA): Correlation found between abundance at diagnosis and persistent diarrhea

  • Phosphorylated p38: Lacks sensitivity, although specific for C difficile infection

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