Clostridioides difficile toxin B gene

Message

Recent BHS guidance:
Based on our case review, we are recommending the following guidance for C. difficile testing and prevention:

Only test for C. difficile if the patient has 3 loose stools in 24 hrs or if there is a high clinical suspicion of disease (e.g., abdominal distention / pain and high WBC)
Do NOT test for C. difficile if the patient has loose stools related to recent lactulose or laxatives; use clinical judgment and consider testing if there are continued loose stools, despite stopping laxatives, or new signs of infection

Please ensure that the following control measures are adhered to in preventing transmission of C. difficile:

Use antibiotics only when necessary, and, where possible, avoid broad-spectrum agents

Start probiotics (called Lactobacillus for Wards, one chewable tablet bid) concurrently if the patient is receiving any antibiotics
Promptly isolate patients with use of gowns and gloves when entering patient room for suspected or confirmed cases of C. difficile
Use of dedicated equipment when feasible and available
Ensure compliance with cleaning of non-dedicated equipment
Adherence to comprehensive environmental cleaning
Perform hand hygiene with soap and water for patients with suspected or confirmed C. difficile. Alcohol-based hand wash is not effective against C. difficile.

Please call Infectious Disease if you have questions regarding prevention, testing, or treatment.

Test Code

C DIFF TOX B GENE PCR

Alias/See Also

C DIFF

Includes

C diff toxin B gene PCR
Nap 1 testing

Preferred Specimen

Liquid or loose Stool

Minimum Volume

1.0 ml

Transport Temperature

Room temperature: ≤ 2 hours

Specimen Stability

Refrigerated (2-8°C): ≤ 5 days

Reject Criteria (Eg, hemolysis? Lipemia? Thaw/Other?)

Do not send solid stools.
Do not use Cary Blair transport media.
Do not send more than one specimen per week.
Do not send stool on swabs

Methodology
PCR

Setup Schedule

Daily

Report Available

TAT
24 hours

Reference Range

Negative

Clinical Significance

Please call Infectious disease if you have questions regarding prevention, testing or treatment.

Performing Laboratory
Test performed in the West Roxbury Microbiology Laboratory
Contact: Scott Connolly 857-203-5954

Additional Information
Stool PCR Collection

Last Updated: February 10, 2025

The CPT Codes provided in this document are based on AMA guidelines and are for informational purposes only. CPT coding is the sole responsibility of the billing party. Please direct any questions regarding coding to the payor being billed. Any Profile/panel component may be ordered separately. Reflex tests are performed at an additional charge.