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Vol. 3(6) July 2014
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Nawar MDNN
Hussein AFA
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Global Advanced
Research Journal of Microbiology (GARJM) ISSN: 2315-5116
July 2014 Vol.
3(6), pp 089-097
Copyright © 2014 Global Advanced
Research Journals
Full Length Research Paper
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Prevalence of
Clostridium difficile among cases of antibiotics
associated diarrhea in hospitalized patients in an
Egyptian hospital
Nada N. Nawar M.D.,
Mona M. A. Haleim M.D., Rasha H. El Shereif M.D.,
Amira F.A. Hussein
Department of Clinical Pathology, Faculty of
Medicine, Cairo University
*Corresponding Author’s Email:
rasha.elsherif@kasralainy.edu.eg;
Tel: 02 0100077557; Tel Fax: 0225080099.
Accepted 09 July, 2014
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Abstract |
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Background and aim of the work: Clostridium
difficile associated diarrhea is an important
nosocomial infection that occurs predominantly after
hospitalization and administration of broad spectrum
antibiotics. In this work we aimed to determine the
prevalence of toxigenic C. difficle among cases of
AAD in Cairo university hospitals in Egypt using
specific Polymerase Chain Reaction protocols.
Patients and methods: Stool samples were collected
from 100 adult cases (19-59 years old) admitted in
wards and ICUs of
Cairo- University hospitals in Egypt,
clinically suffering from AAD and twenty healthy
individuals as a control group and subjected to
direct microscopy examination, culture on blood agar
media and chromognic culture media for C. difficile
and finally molecular detection of C. difficile DNA
using multiplex Polymerase chain Reaction of triose
phosphate isomerase gene tpi, tcdA and tcdB genes
which code for toxin A as an enterotoxin and toxin B
as a cytotoxin respectively and cdtA and cdtB as an
enzymatic and binding component respectively of
binary toxin. Results: Two out of 100 cases were
positive for the ctdB gene (toxin B) and tpi gene
and one of the two positive cases was also positive
for cdtA and cdtB (binary toxin). No cases were
positive for tcdA toxin A. Regarding control group
no samples were positive for any of the tested
genes. Conclusion: This study confirms the accuracy
and reliability of
PCR methodology in the detection of toxigenic C.
difficile, offering combined species identification
and toxigenic type characterization,
and suggests that C. difficile is responsible for a
small, but underappreciated, proportion of
antibiotic associated diarrheal cases in our
country, and further study on a large scale is
warranted in this area.
Keywords: C. difficile ; DNA isolation;
Molecular diagnosis; Health care acquired infection.
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