The aim of this study was to fortify the
clinical importance and representation of toxigenic and non-toxigenic
Clostridium difficile isolated from stool samples of hospitalized
patients. This
survey included 80 hospitalized
patients with
diarrhea and positive findings of
Clostridium difficile in stool samples, and 100 hospitalized
patients with formed stool as a
control group. Bacteriological examination of a stool samples was conducted using standard microbiological
methods. Stool sample were inoculated directly on
nutrient media for bacterial cultivation (
blood agar using 5%
sheep blood, Endo
agar, selective
Salmonella Shigella agar,
Selenite-F broth, CIN
agar and Skirrow's medium), and to selective
cycloserine-
cefoxitin-
fructose agar (CCFA) (Biomedics, Parg qe tehnicologico, Madrid,
Spain) for isolation of
Clostridium difficile.
Clostridium difficile toxin was detected by
ELISA-ridascreen
Clostridium difficile Toxin A/B (R-Biopharm AG,
Germany) and ColorPAC ToxinA test (Becton Dickinson, USA). Examination of stool specimens for the presence of
parasites (causing
diarrhea) was done using standard
methods (conventional
microscopy), commercial concentration test Paraprep S
Gold kit (Dia Mondial,
France) and
RIDA®QUICK
Cryptosporidium/
Giardia Combi test (R-Biopharm AG,
Germany). Examination of stool specimens for the presence of
fungi (causing
diarrhea) was performed by standard
methods. All stool samples positive for
Clostridium difficile were tested for Rota, Noro, Astro and Adeno
viruses by
ELISA - ridascreen (R-Biopharm AG,
Germany). In this
research we isolated 99
Clostridium difficile strains from 116 stool samples of 80 hospitalized
patients with
diarrhea. The 53 (66.25%) of
patients with
diarrhea were positive for toxins A and B, one (1.25%) were positive for only toxin B. Non-toxigenic
Clostridium difficile isolated from samples of 26 (32.5%)
patients. However, other pathogenic microorganisms of intestinal tract cultivated from samples of 16
patients. Examination of cultivated colonies revealed that most of cultivated species belonged to genera of
Campylobacter spp.,
Salmonella spp., and
Candida spp.. In
control group, toxigenic
Clostridium difficile cultivated from stool samples of two
patients (2%) and non-toxigenic
Clostridium difficile from samples of five
patients (5%). This
research confirmed
clinical importance of toxigenic
Clostridium difficile found in liquid stool samples of hospitalized
patient, and the possibility of asymptomatic carriage in 2% of
patients with formed stool.