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|   | Systematic review of 116 included studies between 1978 and 2014.  |   | Systematic review of 116 included studies between 1978 and 2014.  | 
|   |  |   |  | 
| − | ==DIAGNOSIS==
  | + | =DIAGNOSIS=  | 
| − | * Laboratory testing cannot distinguish between asymptomatic colonization and  | + | * Laboratory testing cannot distinguish between asymptomatic colonization and active infection.  | 
| − | ¿Eyed frat' cuitisten a forfindsfficile. The best test performance characteristics
  | + | ==Diagnostic criteria==  | 
| − | ===Diagnostic criteria===
  |   | 
|   | * Diarrhea  |   | * Diarrhea  | 
| − | * Positive stool test for toxigenic C. diff or toxins or pseudomembranous colitis  | + | * Positive stool test for toxigenic C. diff or toxins or visualization of pseudomembranous colitis  | 
| − | ===Diagnostic approaches===
  | + | ==Diagnostic approaches==  | 
|   | * Toxigenic Culture (TC) and/or Cell Cytotoxicity Assay (CCA)  |   | * Toxigenic Culture (TC) and/or Cell Cytotoxicity Assay (CCA)  | 
|   | ** Anaerobic culture for 24-48 hrs followed by colony selection and culture with human cells to test for cell cytotoxicity which takes an additional 24-48 hours.  |   | ** Anaerobic culture for 24-48 hrs followed by colony selection and culture with human cells to test for cell cytotoxicity which takes an additional 24-48 hours.  | 
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|   | * Both positive = C. diff  |   | * Both positive = C. diff  | 
|   | * Both negative = NO C. diff  |   | * Both negative = NO C. diff  | 
| − | * Mixed results, use PCR for tedB as tiebreaker  | + | * Mixed results, use PCR for tcdB as tiebreaker  | 
|   | ** Toxin EIA 1 (Meridian), higher PPV, lower NPV  |   | ** Toxin EIA 1 (Meridian), higher PPV, lower NPV  | 
|   | ** Toxin EIA 2 (TechLab), lower PPV, higher NPV  |   | ** Toxin EIA 2 (TechLab), lower PPV, higher NPV  |