Molecular epidemiology of antibiotic associated diarrhoea due to clostridium dificile and clostridium perfring ensin Ain Shams University Hospitals

ABSTRACT

As we are Iiving in the era of antibiotic overuse, antibiotic associated dlarrhea [AAD] is considered now a distinct health problem with a need for more attention was to perform a highly specific detection and definition of pathogenic Clostridium perfringens and Clostridium difficile related AAD in children compared to adults and geriatircs. One hundred and fifty patients diagnosed for AAD were included in this study [50 children, 50 adults and 50 geriatric patients]. All of them were subjected to full medical history including complete therapeutic history of antibiotics and collection of stool sample during the attack for detection of Clostridium perfingenes enterotoxin [CPEnt] and Clostridium difficile cytotoxin by [EIA] kit. PCR detection of Clostridium perfingenes epegene [Coding gene for CPEnt] was perfomed as well. Results showed that prevalence of Clostridium difficile cytotoxin was 24% while Clostridium perfingenes enterotoxin was 12% as detected by EIA in faecal specimens as a whole. Detection of epe gene by PCR was positive in 16% of all cases. Children [OR 4.2, 95% CI 1.3-14.8, P patients [OR 3.4, 95% CI 1.2-13.5, P Clostridium difficile AAD compared to adults. Also, childhood was a significant risk for Clostridium perfringens AAD [OR 2.1, 95% CI 0.54-7.4, P Children and geriatric patients are more wulnerable to develop AAD with antibiotic abuse compared to adults. AAD= Anibiotic diarrhea, CI=Confidence interval, ELISA=Enzyme-linkedimmunosorbentassay, OR=oddratio, PCR=Polymerase chain reaction