Study of diagnostic methods for detection of clostridium difficile by glutamate dehydrogenase and toxin A/B combination for rapid diagnosis of antibiotic associated causes of diarrhea in pediatric age group

Abstract

Background: Although the reports from India regarding the prevalence of C. difficile in children are scanty, the actual estimated picture of CDI in our country could be more because the detection of C. difficile requires tedious and costly anaerobic techniques. In the present study we aimed to evaluate diagnostic methods for detection of Clostridium difficile by glutamate dehydrogenase and toxin A/B combination for rapid diagnosis of antibiotic associated causes of diarrhea in pediatric age group. Material and Methods: Present study was single-center, descriptive observational cross-sectional study, conducted in pediatric age group patients (< 13years), hospitalized for diarrhea and receiving antibiotics for more than 5 days, underwent detection of GDH and toxin A/ B by rapid kit-based test. Results: Out of 120 cases, majority of the cases were in age group of 7- 9 years (31.67 %) and male to female ratio was 1.93:1. 76.67 % cases had fever; 78.33 % cases developed diarrhea; 42.5 % cases complained of pain in abdomen. 24.16% of the cases were GDH positive, 15.83% males and 8.33% females; 11.66% of the cases were toxin positive, 5.83% males and 5.83% females; 22.5% of the cases were culture positive, 14.16% males and 8.33% females. The toxin positivity rate amongst the GDH positives was 48.27%; 14 cases out of the total 29 cases of GDH positives; 36.84% in males and 70% in females; statistically significant difference between GDH positivity and toxin positivity. The toxin positivity rate amongst the culture positives was 51.85%; 14 cases out of the total 27 cases of culture positives; 41.17% in males and 70% in females; statistically significant difference between culture positivity and toxin positivity. Conclusion: Rapid test provide quick easy and cost effective means of accurately diagnosing CDI. The use of such test to screen both GDH and toxin A/B will allow the laboratory to detect more samples without having to test these specimens to more expensive and time-consuming test like cultures, EIA and PCR.