STUDY OF TOXIN PRODUCTION IN PATIENTS WITH CLOSTRIDIUM DIFFICILE ASSOCIATED DIARRHOEA

Abstract

Introduction: Clostridium difcile infection (CDI) is dened as the presence of diarrheal symptoms and either a stool test result positive for C. difcile toxins or detection of toxigenic C. difcile, or colonoscopic ndings demonstrating pseudomembranous colitis. C.difcile produces toxin A (enterotoxin) and B (cytotoxin), under favorable conditions. Both toxins severely affect GIT. The relationship between the amount of toxins in the feces and the severity of symptoms has been found. Aim & Objectives : To detect C.difcile toxin production in stool samples with laboratory conrmed CDI and to correlate the presence of toxin with disease severity Material & Methods: A prospective laboratory based study done in a tertiary care Medical college and allied hospitals in Gwalior (MP) in a duration of 11 months, which included stool samples of 118 patients with laboratory conrmed CDI. Toxin levels in stool samples were detected and correlated with the clinical condition. Toxin A & B study were performed on stool sample with ELFA (Enzyme Linked Fluorescent Assay) technology (VIDAS instruments). Results and Discussion: 118 patients with laboratory conrmed CDI. Toxin levels in stool samples were detected in 08 patients. The toxin positivity rate was 6.79%. All of these hospitalized patients had severe diarrhea and history of administration of broad spectrum antibiotics Conclusion: Signicant toxin load in the fecal samples may be associated with the signicant deterioration of the general condition of the patient.