A hospital outbreak of Clostridium difficile?

An increase in numbers of patients with Clostridium difficile and its toxin in their stools at a hospital in South-west London led to closure of a ward to admissions and to an investigation of a possible nosocomial outbreak. The findings suggested that the increase was not due to an outbreak of related cases but to increased investigation. The cost of the episode both in financial terms and in the effect on patient care, was considerable. This study highlights the need for caution in interpreting the significance of Cl. difficile in stool specimens. Laboratory data can only alert clinicians to the possibility of colitis; decisions about treatment and control of spread of infection should also be based on clinical criteria.