Clostridium difficile-associated diarrhoea in uremic patients.

An outbreak of 94 episodes of Clostridium difficile-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 with Clostridium difficile, and no other bacterial pathogens were isolated. Thirty-two relapses occurred in 16 patients, fourteen of the relapses without preceding antibiotic exposure. Clostridium difficile could not be isolated from the environment of the patients. Uremic patients, who had a significantly increased number of Clostridium spp. in their stools, are predisposed to Clostridium difficile infections.