Simultaneous assays for Clostridium difficile and faecal lactoferrin in ulcerative colitis.

Infectious agents may be one of the important factors in initiating or perpetuating ulcerative colitis. Increasing evidence has accumulated regarding the role of Clostridium difficile (C. difficile) infection in the exacerbation of ulcerative colitis. The present work was undertaken to study the implications of C. difficile toxin (CDT) and faecal lactoferrin (FL) positivity in patients with idiopathic ulcerative colitis (IUC) in a north Indian hospital. Ninety-four faecal samples from patients of IUC were processed for CDT and FL simultaneously. Clinical details of patients, including antibiotic intake in the past 6 weeks, were recorded. Eighty-one of the 94 patients (86.2%) had diarrhoea and 48 (51.1%) had received antibiotics. There was a statistically significant (p < 0.001) increase in the prevalence of diarrhoea among individuals receiving antibiotics. Twelve of the 94 samples (12.8%) were CDT positive while 16 were FL positive. No statistical significance (p > 0.05) was seen while comparing the positivity of CDT and FL in relation to the receipt of antibiotics. A statistically significant (p < 0.001) positive correlation was present between CDT and FL assays. FL positivity in IUC may depend on the intestinal inflammation precipitated by C. difficile infection.

Faecal lactoferrin assay as an adjunct to Clostridium difficile diarrhoea.

Inflammation is the hallmark of Clostridium difficile associated diarrhoea and lactoferrin is produced by inflammatory cells. The aim of this study was to find out whether faecal lactoferrin latex agglutination (FLLA) assay done simultaneously with Clostridium difficile toxin (CDT) assay would help in the diagnosis of C. difficile infection in paediatric patients. One hundred and fifty faecal samples were obtained from paediatric group of patients. Both FLLA and CDT assays were done in conjunction on these samples. The data were expressed by descriptive statistics. One hundred and nineteen patients received antibiotics while 31 did not receive it. Of the former group 89 (74.8%) had diarrhoea while 30 (25.2%) did not have it. No significant relationship (p=0.287) was seen between antibiotic usage and occurrence of diarrhoea. However, CDT positivity was seen to be influenced by prior antibiotic usage as 51 (42.9%) patients receiving antibiotics were CDT positive when compared to 4 (7.3%) of those who did not receive antibiotics (p=0.002). A highly statistically significant (p<0.001) relationship was seen between CDT and FLLA positivity. FLLA appears to be an useful adjunct for C. difficile associated intestinal diseases in children when both the tests are done simultaneously and when other enteropathogens causing inflammatory diarrhoeas are ruled out.