The Frequency of Toxigenic Strains of Clostridium difficile in Hospitalized Patients with Diarrhea in Tehran/Iran by PCR Method, 2010

Abstract

Abstract: Background & Aims: Clostridium difficile has been identified as a pathogen in antibiotic associated diarrhea (AAD), pseudomembranous colitis and also nosocomial diarrhea. The present study was performed to find the prevalence of toxigenic strains of C .difficile isolated from diarrhea patients hospitalized in Tehran hospitals. Method: A total of 98 fecal samples obtained during July to December 2010 were studied. Samples were rapidly cultured on the CCFA medium and incubated at the anaerobic conditions. Then ELISA was done to detect toxin A and B in the stool. Molecular identification of C.difficile was done by cdd3 universal primer and toxin A gene (tcdA), toxin B gene (tcdB) and binary toxin profiles were determined by PCR method. Results: from a total of 98 fecal samples, 15 samples (15.3%) were positive of which, 12 strains (21.2%) were A+B+, 2 strains (2%) were A+B-, and 1 strain (1%) was A-B+. Conclusion: This study showed that Clostridium difficile is an important pathogen in the development of nosocomial diarrhea. Therefore, routine detection of C.difficile in suspected cases is recommended. Keywords: Clostridium difficile, C. difficile enterotoxin A, C. difficile enterotoxin B, Diarrhe