Frequency of antibiotic associated diarrhea caused by Clostridium difficile among hospitalized patients in intensive care unit, Kerman, Iran

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REZAZADEH ZARANDI EBRAHIM; MANSOURI SHAHLA; NAKHAEE NOUZAR; SARAFZADEH FARHAD; IRANMANESH ZAHRA; MORADI MOHAMMAD

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Journal: Gastroenterology and Hepatology From Bed to Bench Year:2017 | Volume:10 | Issue:3 Page(s): 229-234

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Title

Frequency of antibiotic associated diarrhea caused by Clostridium difficile among hospitalized patients in intensive care unit, Kerman, Iran

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Keywords

Clostridium difficile

Intensive Care Unit

CDAD

Abstract

Aim: This study evaluated the frequency of C. difficile and CDAD in the ICU of Shahid Bahonhar Hospital, Kerman, Iran. Background: Clostridium difficile (C. difficile) is the most important antibiotic associated diarrhea agent in Intensive Care Unit (ICU) patients. Based on its toxin producing ability, C. difficile is divided to toxigenic and non-toxigenic strains. Methods: A total of 233 diarrheal samples were collected from ICU patients. The samples were cultured on Clostridium difficile medium with 5% defibrinated sheep blood containing cycloserine (500 mg/L), cefoxitin (16 mg/L) and lysozyme (5mg/L). The isolates were confirmed as C. difficile by polymerase chain reaction (PCR) of 16s rRNA gene and the presence of toxins genes (tcdA, tcdB, cdtA and cdtB) was also confirmed. Then, the toxin production of isolates was evaluated using ELISA. Results: C. difficile was isolated from 49 (21%) out of 233 samples. The total isolates fell into the A-/B-/CDT-(48. 97%), A+/B-/CDT-(28%), A+/B+/CDT-(20. 4%) and A+/B+/CDT+ (2%) types. Both types of C. difficile, A-/B-/CDT-and A+/B-/CDT-, which account for 77. 5% of all isolates, were unable to produce the toxin (nontoxigenic). On the other hand, A+/B+/CDT+ and A+/B+/CDT-(22. 5%), were able to produce toxin or were toxigenic. Conclusion: The frequency of C. difficile was about 21% and only 22. 4% of C. difficile isolates were able to produce toxins. It is expected that C. difficile A+/B+/CDT± are toxigenic and related to C. difficile associated diarrhea (CDAD). Additionally, about 4. 7% of hospitalized patients in ICU suffered from CDAD, which is higher than the rates reported from industrialized countries. Notably, 28% of isolates were C. difficile A+/B-/CDT-which only carries tcdA genes without toxin production.

Cites

Toxin profiles and antimicrobial resistance patterns among toxigenic clinical isolates of Clostridioides (Clostridium) difficile

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APA: Copy

REZAZADEH ZARANDI, EBRAHIM, MANSOURI, SHAHLA, NAKHAEE, NOUZAR, SARAFZADEH, FARHAD, IRANMANESH, ZAHRA, & MORADI, MOHAMMAD. (2017). Frequency of antibiotic associated diarrhea caused by Clostridium difficile among hospitalized patients in intensive care unit, Kerman, Iran. GASTROENTEROLOGY AND HEPATOLOGY FROM BED TO BENCH, 10(3), 229-234. SID. https://sid.ir/paper/324858/en

Vancouver: Copy

REZAZADEH ZARANDI EBRAHIM, MANSOURI SHAHLA, NAKHAEE NOUZAR, SARAFZADEH FARHAD, IRANMANESH ZAHRA, MORADI MOHAMMAD. Frequency of antibiotic associated diarrhea caused by Clostridium difficile among hospitalized patients in intensive care unit, Kerman, Iran. GASTROENTEROLOGY AND HEPATOLOGY FROM BED TO BENCH[Internet]. 2017;10(3):229-234. Available from: https://sid.ir/paper/324858/en

IEEE: Copy

EBRAHIM REZAZADEH ZARANDI, SHAHLA MANSOURI, NOUZAR NAKHAEE, FARHAD SARAFZADEH, ZAHRA IRANMANESH, and MOHAMMAD MORADI, “Frequency of antibiotic associated diarrhea caused by Clostridium difficile among hospitalized patients in intensive care unit, Kerman, Iran,” GASTROENTEROLOGY AND HEPATOLOGY FROM BED TO BENCH, vol. 10, no. 3, pp. 229–234, 2017, [Online]. Available: https://sid.ir/paper/324858/en

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