Clostridium difficile-Associated diarrhoea in uremic patients

An outbreak of 94 episodes ofClostridiumdifficile-associated diarrhoea in 62 patients in a nephrology ward over a two-year period was investigated. Quantitative stool cultures were performed on ten uremic patients not on antibiotics and without diarrhoea and on ten healthy controls. All diarrhoeal episodes were associated withClostridium difficile,and no other bacterial pathogens were isolated. Thirty-two relapses occurred in 16 patients, fourteen of the relapses without preceding antibiotic exposure.Clostridium difficilecould not be isolated from the environment of the patients. Uremic patients, who had a significantly increased number ofClostridiumspp. in their stools, are predisposed toClostridium difficileinfections.