Improved detection of toxigenic Clostridium difficile using the Cepheid Xpert C difficile assay and impact on C difficile infection rates in a tertiary hospital: a double-edged sword.

Recent recommendations suggest implementation of a 2-step diagnostic algorithm for the laboratory detection of toxigenic Clostridium difficile. We found that the rate of toxigenic C difficile detection in our laboratory doubled after the introduction of an algorithm that incorporated polymerase chain reaction testing. This led to an abrupt 70% increase in the overall rate of C difficile infection in our institution.