title: Detection of Clostridium difficile and its toxin A (TcdA) in stool specimens from hospitalised patients.
abstract: The study has been carried out to determine the frequency of C. difficile recovery in stool cultures and the rate of C. difficile toxin A detection in faecal specimens of patients with nosocomial diarrhoea. Clinical specimens comprised 4414 stool samples collected from 1998 to 2002 from adult patients hospitalised in different wards of a university-affiliated hospital (1200 beds) and suspected of C. difficile-associated disease (CDAD). There have been 1308 (29.6%) specimens positive for C. difficile culture (15.1% in 1998, 29.5% in 1999, 33.8% in 2000, 31.2% in 2001 and 32.0% in 2002). The highest number of C. difficile strains was cultured from stool samples of patients hospitalised in the haematology/oncology ward (51.1% of all isolates), neurology (8.3%), nephrology (8.0%), gastrointestinal surgery (7.0%) and neurosurgery (6.2%) wards. The testing for C. difficile toxin A yielded 847 (19.2%) positive samples and 3567 (80.8%) toxin A-negative results. The percentage of C. difficile toxin A-positive samples was 29.4% in 1998, 17.5% in 1999, 23.2% in 2000, 17.1% in 2001 and 15.0% in 2002. In the analysed period we observed an increase in the number of stool specimens tested for C. difficile and an increase in the number of C. difficile culture-positive samples. A decrease in the number of C. difficile toxin A-positive samples was noted in the last 2 years of the study. This phenomenon may be due to an improved antibiotic policy of the hospital.
authors.affiliation: Chair and Department of Medical Microbiology, Medical University of Warsaw, 5 Chalubinskiego Street, 02-004 Warsaw, Poland. wroblewska@ib.amwaw.edu.pl
authors.forename: Marta M
authors.initials: MM
authors.lastname: Wróblewska
authors.forename: Ewa
authors.initials: E
authors.lastname: Swoboda-Kopeć
authors.forename: Alicja
authors.initials: A
authors.lastname: Rokosz
authors.forename: Grazyna
authors.initials: G
authors.lastname: Nurzyńska
authors.forename: Agnieszka
authors.initials: A
authors.lastname: Bednarska
authors.forename: Mirosław
authors.initials: M
authors.lastname: Luczak
mesh_terms: D000900:Anti-Bacterial Agents / Q000009:adverse effects; D001427:Bacterial Toxins / Q000032:analysis*; D016360:Clostridioides difficile / Q000235:genetics / Q000302:isolation & purification* / Q000472:pathogenicity; D003428:Cross Infection / Q000175:diagnosis / Q000453:epidemiology / Q000382:microbiology*; D003967:Diarrhea / Q000175:diagnosis / Q000453:epidemiology / Q000382:microbiology*; D004761:Enterocolitis, Pseudomembranous / Q000175:diagnosis / Q000453:epidemiology / Q000382:microbiology; D004768:Enterotoxins / Q000032:analysis*; D005243:Feces / Q000737:chemistry* / Q000382:microbiology*; D006786:Hospitals, Urban; D006801:Humans
chemical_list: D000900:Anti-Bacterial Agents; D001427:Bacterial Toxins; D004768:Enterotoxins; C041348:tcdA protein, Clostridium difficile