Molecular epidemiology of antibiotic-associated diarrhoea due to Clostridium difficile and clostridium perfringens in Ain Shams University Hospitals
Background: As we are living in the era of antibiotic overuse, antibiotic associated diarrhea (AAD) is considered now a distinct health problem with a need for more attention. Aim of the Study: 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. Patients and Methods: 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 perfringenes enterotoxin (CPEnt) and Clostridium difficile cytotoxin by (EIA) kit. PCR detection of Clostridium perfringenes cpe gene (Coding gene for CPEnt) was performed as well. Results: Results showed that prevalence of Clostridium difficile cytotoxin was 24% while Clostridium perfringenes enterotoxin was 12% as detected by EIA in faecal specimens as a whole. Detection of cpe gene by PCR was positive in 16% of all cases. Children (OR: 4.2, 95% CI: 1.3-14.8, P_0.01) and geriatric patients (OR: 3.4, 95% CI: 1.2-13.5, P_0.02) were significantly more prone to 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_0.04). In Conclusion: children and geriatric patients are more vulnerable to develop AAD with antibiotic abuse compared to adults. Abbreviations: AAD=Antibiotic associated diarrhea, CI=Confidence interval, ELISA=Enzyme-linked immunosorbent assay, OR=Odd ratio, PCR=Polymerase chain reaction.
Keywords: Antibiotic-associated diarrhea, children, Clostridium perfringens, Clostridium difficile.
Egypt. J. Hum. Genet Vol. 8 (2) 2007: pp. 121-130