Laboratory diagnosis of antibiotic-associated diarrhea: a Polish pilot study into the clinical relevance of Clostridium difficile and Clostridium perfringens toxins.
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.
Pituch
Hanna
H
Department of Medical Microbiology, Medical University of Warsaw, 02-004 Warsaw, Poland. hanna.pituch@ib.amwaw.edu.pl
Obuch-Woszczatyński
Piotr
P
Wultańska
Dorota
D
van Belkum
Alex
A
Meisel-Mikołajczyk
Felicja
F
Łuczak
Mirosław
M
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
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