title: Laboratory diagnosis of antibiotic-associated diarrhea: a Polish pilot study into the clinical relevance of Clostridium difficile and Clostridium perfringens toxins.
abstract: In the present study, we investigated the prevalence of the Clostridium perfringens enterotoxin (CPEnt) in stool samples originally submitted for detection of Clostridium difficile toxins. Fifty-two fecal samples from inpatients were screened simultaneously for C. difficile and C. perfringens toxins: 75% of the specimens were positive for TcdA/TcdB toxins, 40% were positive for CPEnt, and 31% gave positive test results for both. It is interesting to note that only a relatively small number of C. perfringens isolates were positive for the cpe gene. All C. difficile strains were susceptible to metronidazole, but intermediate metronidazole resistance was documented for the C. perfringens isolates, which decreased upon in vitro passaging in the absence of metronidazole. We recommend that CPEnt detection should be included when diagnosing patients with presumed antibiotic-associated diarrhea.
authors.affiliation: Department of Medical Microbiology, Medical University of Warsaw, 02-004 Warsaw, Poland. hanna.pituch@ib.amwaw.edu.pl
authors.forename: Hanna
authors.initials: H
authors.lastname: Pituch
authors.forename: Piotr
authors.initials: P
authors.lastname: Obuch-Woszczatyński
authors.forename: Dorota
authors.initials: D
authors.lastname: Wultańska
authors.forename: Alex
authors.initials: A
authors.lastname: van Belkum
authors.forename: Felicja
authors.initials: F
authors.lastname: Meisel-Mikołajczyk
authors.forename: Mirosław
authors.initials: M
authors.lastname: Łuczak
mesh_terms: D000890:Anti-Infective Agents / Q000494:pharmacology; D001426:Bacterial Proteins / Q000235:genetics; D001427:Bacterial Toxins / Q000235:genetics; D016360:Clostridioides difficile / Q000187:drug effects / Q000235:genetics / Q000302:isolation & purification* / Q000378:metabolism; D003016:Clostridium perfringens / Q000187:drug effects / Q000235:genetics / Q000302:isolation & purification* / Q000378:metabolism; D003967:Diarrhea / Q000453:epidemiology / Q000209:etiology / Q000382:microbiology; D004761:Enterocolitis, Pseudomembranous / Q000175:diagnosis* / Q000453:epidemiology* / Q000382:microbiology; D004768:Enterotoxins / Q000235:genetics*; D005243:Feces / Q000737:chemistry / Q000382:microbiology; D006801:Humans; D008795:Metronidazole / Q000494:pharmacology; D008826:Microbial Sensitivity Tests; D010865:Pilot Projects; D011044:Poland / Q000453:epidemiology; D016133:Polymerase Chain Reaction; D015995:Prevalence
chemical_list: D000890:Anti-Infective Agents; D001426:Bacterial Proteins; D001427:Bacterial Toxins; D004768:Enterotoxins; C035598:enterotoxin, Clostridium; C041348:tcdA protein, Clostridium difficile; C031815:toxB protein, Clostridium difficile; D008795:Metronidazole