Background: Clostridium difficile is a significant cause of nosocomial diarrhea. We sought to determine the role of bacterial pathogens in patients with infectious colitis in our community. Methods: We reviewed the records of patients who were tested positive for C. difficile toxin A or B by enzyme-linked immunosorbent assay, or had a positive stool culture for a bacterial pathogens. Results: A total of 1374 patients had positive C. difficile toxin assays; 67 had positive cultures for other bacterial pathogens. Of the patients with C. difficile, 568 were outpatients, whereas 804 were inpatients. Four hundred eighty-eight (83) of outpatients were extended-care facility residents. Detection of C. difficile toxin was preceded within 2 months by a urine culture in 32 6 of the outpatients; half of these had a positive urine culture. Conclusions: C. difficile is the most common identifiable bacterial pathogen among patients with infectious colitis in our community. Patients with C. difficile toxin detection were likely to have a suspected urinary tract infection. We speculate that empiric antibiotics for urinary tract infections may contribute to the higher C. difficile toxin detection in these patients.
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