Abstract
Clostridium difficile is an anaerobic, spore bearing bacteria can colonize hospitalized patients commonly. Toxin producing strains are an important cause of nosocomial diarrhea. Though various testing methods are available for the diagnosis of C. difficile infection (CDI) but, correct diagnosis is still a challenge for laboratories. To study the positivity of the infection by multiple testing methods available. This is an observational study. A total of 1429 freshly passed stool samples received in the Department of Microbiology from February 2019-May 2020 were included in the study. Further, the samples (1415) were tested for presence of Glutamate Dehydrogenase antigen (GDH Ag), toxin A, toxin B by an ICT (immunochromatography test) from Vittassay. A total of 48 samples were tested by GeneXpert (Cepheid) PCR (Polymerase Chain Reaction). Out of these, 14 samples were tested by PCR alone &34 samples were tested by both ICT & PCR. A total of 188(13.2%) samples received, from 165 patients including 94(57%) male patients & 71(43%) female patients, were found positive for CDI. Out of these, 184(13%) samples were found positive for GDH Ag screening in ICT. Among, 48 PCR tested samples, 5(10.4%) were detected positive for tcdtB gene. A total of 97(6.8%) samples showed the presence of toxins. Multiple algorithm of testings is required to increase the sensitivity of the diagnosis, but high cost is a limiting factor in the developing countries.
Highlights
Clostridium difficile (C.difficile) is an anaerobic, sporeforming bacillus causing antibiotic-associated diarrhea & pseudomembranous colitis
Out of these 1415 samples were tested by immunochromatographic test (ICT) for presence of GDH Ag/Toxin A/B, 48 samples were tested by PCR & 34 samples were tested by both ICT & PCR.(Figure 1)
Out of all 187(13.21%) samples were found positive by ICT
Summary
Clostridium difficile (C.difficile) is an anaerobic, sporeforming bacillus causing antibiotic-associated diarrhea & pseudomembranous colitis. It colonizes 2% of healthy people & 3-26% of individuals in a hospital setting. 7–9 Detection of these toxigenic strains in stool is necessary to initiate early therapy & to implement infection control measures. Aim: To study the positivity of the infection by multiple testing methods available. The samples (1415) were tested for presence of Glutamate Dehydrogenase antigen (GDH Ag), toxin A, toxin B by an ICT (immunochromatography test) from Vittassay. Conclusion: Multiple algorithm of testings is required to increase the sensitivity of the diagnosis, but high cost is a limiting factor in the developing countries
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