Toxigenic Clostridium difficile Infection in Children: Performance of Toxin A/B Immunoassay

Objectives: Clostridium difficile is a major nosocomial pathogen that infects the large intestine (colon) and causes a range of clinical manifestations from mild to severe diarrhea. The aim of this study was to assess the detection of pathogenic toxin A/B-positive C. difficile strains among hospital...

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Main Authors: Jalal Mardaneh, Alireza Mohammadzadeh, Saeede Bagheri, Maryam Baniasadi, Masoud Yousefi, Gholamreza Pouladfar, Mojtaba Anvarinejad
Format: Article
Language:English
Published: Aras Part Medical International Press 2021-04-01
Series:Crescent Journal of Medical and Biological Sciences
Subjects:
Online Access:http://www.cjmb.org/pdf.php?id=486
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author Jalal Mardaneh
Alireza Mohammadzadeh
Saeede Bagheri
Maryam Baniasadi
Masoud Yousefi
Gholamreza Pouladfar
Mojtaba Anvarinejad
author_facet Jalal Mardaneh
Alireza Mohammadzadeh
Saeede Bagheri
Maryam Baniasadi
Masoud Yousefi
Gholamreza Pouladfar
Mojtaba Anvarinejad
author_sort Jalal Mardaneh
collection DOAJ
description Objectives: Clostridium difficile is a major nosocomial pathogen that infects the large intestine (colon) and causes a range of clinical manifestations from mild to severe diarrhea. The aim of this study was to assess the detection of pathogenic toxin A/B-positive C. difficile strains among hospitalized patients with diarrhoea in Gonabad, Iran. Materials and Methods: In this cross-sectional study, hospitalized patients submitted to 22 Bahman Hospital (Gonabad, Iran) were included if they had a liquid stool specimen. From November 2016 through July 2017, a total of 50 sequential stool samples (unformed or liquid) were obtained from hospitalized patients for inclusion in this study. The stool samples were collected and C. difficile toxin A/B immunoassay was performed according to the manufacturer’s guidelines. Results: Based on the results, the maximum number of cases belonged to the age group of less than 10 years (n=29, 58%). Most studied patients were hospitalized in the pediatrics ward (n=24, 48%). Among the studied patients, 16 (32%) cases were positive for C. difficile toxin A/B by immunochromatographic assay. Frothy-four (88%) patients received one or more antibiotic treatment on admission and hospitalization. Ceftriaxone was the most common applied drug for the treatment of these patients. Finally, 5 (31.25%) patients received combination therapy. Overall, 34.48% of pediatric cases were positive for C. difficile toxin A/B. Conclusions: Our results showed that the emergence of potentially highly virulent and antibiotic-resistant C. difficile isolates is alarming. The diagnostic of pathogenic C. difficile by the clinical microbiology laboratory can improve the handling of disease and more reasonable use of antimicrobials by the physician.
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spelling doaj.art-89bfedcb99134db5a9c6c5f3f5857b292022-12-21T23:45:14ZengAras Part Medical International PressCrescent Journal of Medical and Biological Sciences2148-96962021-04-0182122126cjmb-44Toxigenic Clostridium difficile Infection in Children: Performance of Toxin A/B ImmunoassayJalal Mardaneh0Alireza Mohammadzadeh1Saeede Bagheri2Maryam Baniasadi3Masoud Yousefi4Gholamreza Pouladfar5Mojtaba Anvarinejad6Department of Microbiology, School of Medicine, Infectious Diseases Research Center, Gonabad University of Medical Sciences, Gonabad, Iran.Department of Microbiology, School of Medicine, Infectious Diseases Research Center, Gonabad University of Medical Sciences, Gonabad, Iran.Student Research Committee, Gonabad University of Medical Sciences, Gonabad, Iran.Laboratory of Microbiology, Allame Bohlool Hospital, Gonabad University of Medical Sciences, Gonabad, Iran.Department of Microbiology, School of Medicine, Birjand University of Medical Sciences, Birjand, Iran.Professor Alborzi Clinical Microbiology Research Center, Nemazee Hospital, Shiraz University of Medical Sciences, Shiraz, Iran.Professor Alborzi Clinical Microbiology Research Center, Nemazee Hospital, Shiraz University of Medical Sciences, Shiraz, Iran.Objectives: Clostridium difficile is a major nosocomial pathogen that infects the large intestine (colon) and causes a range of clinical manifestations from mild to severe diarrhea. The aim of this study was to assess the detection of pathogenic toxin A/B-positive C. difficile strains among hospitalized patients with diarrhoea in Gonabad, Iran. Materials and Methods: In this cross-sectional study, hospitalized patients submitted to 22 Bahman Hospital (Gonabad, Iran) were included if they had a liquid stool specimen. From November 2016 through July 2017, a total of 50 sequential stool samples (unformed or liquid) were obtained from hospitalized patients for inclusion in this study. The stool samples were collected and C. difficile toxin A/B immunoassay was performed according to the manufacturer’s guidelines. Results: Based on the results, the maximum number of cases belonged to the age group of less than 10 years (n=29, 58%). Most studied patients were hospitalized in the pediatrics ward (n=24, 48%). Among the studied patients, 16 (32%) cases were positive for C. difficile toxin A/B by immunochromatographic assay. Frothy-four (88%) patients received one or more antibiotic treatment on admission and hospitalization. Ceftriaxone was the most common applied drug for the treatment of these patients. Finally, 5 (31.25%) patients received combination therapy. Overall, 34.48% of pediatric cases were positive for C. difficile toxin A/B. Conclusions: Our results showed that the emergence of potentially highly virulent and antibiotic-resistant C. difficile isolates is alarming. The diagnostic of pathogenic C. difficile by the clinical microbiology laboratory can improve the handling of disease and more reasonable use of antimicrobials by the physician.http://www.cjmb.org/pdf.php?id=486hospitalized patientschildrendiarrheatoxigenic clostridium difficile
spellingShingle Jalal Mardaneh
Alireza Mohammadzadeh
Saeede Bagheri
Maryam Baniasadi
Masoud Yousefi
Gholamreza Pouladfar
Mojtaba Anvarinejad
Toxigenic Clostridium difficile Infection in Children: Performance of Toxin A/B Immunoassay
Crescent Journal of Medical and Biological Sciences
hospitalized patients
children
diarrhea
toxigenic clostridium difficile
title Toxigenic Clostridium difficile Infection in Children: Performance of Toxin A/B Immunoassay
title_full Toxigenic Clostridium difficile Infection in Children: Performance of Toxin A/B Immunoassay
title_fullStr Toxigenic Clostridium difficile Infection in Children: Performance of Toxin A/B Immunoassay
title_full_unstemmed Toxigenic Clostridium difficile Infection in Children: Performance of Toxin A/B Immunoassay
title_short Toxigenic Clostridium difficile Infection in Children: Performance of Toxin A/B Immunoassay
title_sort toxigenic clostridium difficile infection in children performance of toxin a b immunoassay
topic hospitalized patients
children
diarrhea
toxigenic clostridium difficile
url http://www.cjmb.org/pdf.php?id=486
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