title: Prevalence of gastrointestinal pathogenic bacteria in patients with diarrhoea attending Groote Schuur Hospital, Cape Town, South Africa.
abstract: BACKGROUND
  Diarrhoea due to gastrointestinal infections is a significant problem facing the South African (SA) healthcare system. Infections can be acquired both from the community and from the hospital environment itself, the latter acting as a reservoir for potential pathogenic bacteria.
  
  
  OBJECTIVE
  To examine the prevalence of a panel of potential diarrhoea-causing bacteria in patients attending a tertiary healthcare facility in Cape Town, SA.
  
  
  METHODS
  Polymerase chain reaction (PCR) primers specific for Clostridium difficile, Shigella spp., Salmonella spp., Klebsiella oxytoca, enteropathogenic and enterohaemorrhagic Escherichia coli (EPEC/EHEC), Staphylococcus aureus, enterotoxigenic Bacteroides fragilis and Campylobacter spp. were used to screen total bacterial genomic DNA extracted from stool samples provided by 156 patients with diarrhoea attending Groote Schuur Hospital, Cape Town, SA.
  
  
  RESULTS
  C. difficile was the most frequently detected pathogen (16% of cases) in the 21-87-year-old patient range, but was not present in samples from the 16-20-year-old range. K. oxytoca (6%), EPEC/EHEC strains (9%) and S. aureus (6%) were also detected. The remaining pathogens were present at low frequencies (0-2.9%), and the occurrence of mixed infections was 5%. The majority of non-C. difficile-related diarrhoeas were community acquired.
  
  
  CONCLUSIONS
  C. difficile was the main cause of infectious diarrhoea in the sampled patients, while K. oxytoca and EPEC/EHEC strains were present as relatively minor but potentially significant pathogens.
authors.affiliation: Department of Molecular and Cell Biology, Faculty of Science, University of Cape Town, South Africa. br.kullin@uct.ac.za.
authors.forename: Brian
authors.initials: B
authors.lastname: Kullin
authors.forename: Rosemary
authors.initials: R
authors.lastname: Meggersee
authors.forename: Jerrard
authors.initials: J
authors.lastname: D'Alton
authors.forename: Bruna
authors.initials: B
authors.lastname: Galvao
authors.forename: Naayil
authors.initials: N
authors.lastname: Rajabally
authors.forename: Andrew
authors.initials: A
authors.lastname: Whitelaw
authors.forename: Colleen
authors.initials: C
authors.lastname: Bamford
authors.forename: Sharon J
authors.initials: SJ
authors.lastname: Reid
authors.forename: Valerie Rose
authors.initials: VR
authors.lastname: Abratt
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001419:Bacteria / Q000235:genetics / Q000302:isolation & purification*; D001424:Bacterial Infections / Q000453:epidemiology* / Q000382:microbiology; D004269:DNA, Bacterial / Q000032:analysis; D003967:Diarrhea / Q000453:epidemiology* / Q000382:microbiology; D005260:Female; D041981:Gastrointestinal Tract / Q000382:microbiology*; D006801:Humans; D008875:Middle Aged; D010343:Patient Admission / Q000706:statistics & numerical data*; D016133:Polymerase Chain Reaction; D015995:Prevalence; D012189:Retrospective Studies; D013019:South Africa / Q000453:epidemiology; D062606:Tertiary Care Centers; D055815:Young Adult
chemical_list: D004269:DNA, Bacterial