True regarding pseudomembranous colitis are all except:
“Cl. difficile cause pseudomembranous colitis (PMC) due to the production of toxin A (enterotoxin) and toxin B (cytotoxin), not phospholipase A.”

Toxin A is a potent neutrophil chemoattractant and both toxin A and B glucosylate the GTP binding protein of Rho subfamily resulting in disruption of cytoskeleton causing loss of cell shape adherence with consequent fluid leakage.
Asymptomatic fecal carriage of Cl. difficile in healthy neonates is very common. It also colonizes the colon of 3% of healthy adults.

CMDT’ 08, p 543

For Cl. difficile associated diarrhea (CDAD), three events are essential:
It is caused by Clostridium difficile
The organism is a normal commensal of gut
It is due to production of phospholipase A
It is treated by vancomycin