title: Clostridium difficile infections among adults and children in Mwanza/Tanzania: is it an underappreciated pathogen among immunocompromised patients in sub-Saharan Africa?
abstract: Little is known regarding the epidemiology Clostridium difficile in developing countries. Fresh stool samples from patients with diarrhoea were cultured anaerobically. C. difficile was detected in nine (6.4%) of 141 (95% confidence interval 4.2-13.1), of which seven (77.8%) were from children. HIV infection, prolonged hospitalization and antibiotic use were independent factors associated with the occurrence of C. difficile in the gastrointestinal tract. Two of the toxigenic isolates were typed as ribotype 045, and the other two had unknown ribotype. All C. difficile isolates were susceptible to metronidazole, moxifloxacin and clarithromycin, while three isolates were resistant to clarithromycin. C. difficile may be an important pathogen causing diarrhoea in sub-Saharan Africa among immunocompromised patients.
authors.affiliation: Department of Pediatric and Child Health, Weill Bugando School of Medicine, Mwanza, Tanzania.
authors.forename: M
authors.initials: M
authors.lastname: Seugendo
authors.affiliation: Department of Microbiology, Weill Bugando School of Medicine, Mwanza, Tanzania.
authors.forename: S E
authors.initials: SE
authors.lastname: Mshana
authors.affiliation: Department of Pediatric and Child Health, Weill Bugando School of Medicine, Mwanza, Tanzania.
authors.forename: A
authors.initials: A
authors.lastname: Hokororo
authors.affiliation: Department of Biochemistry and Molecular Biology, Weill Bugando School of Medicine, Mwanza, Tanzania.
authors.forename: B
authors.initials: B
authors.lastname: Okamo
authors.affiliation: Department of Microbiology, Weill Bugando School of Medicine, Mwanza, Tanzania.
authors.forename: M M
authors.initials: MM
authors.lastname: Mirambo
authors.affiliation: Institute for Medical Microbiology and Hygiene, German Reference Laboratory for Clostridium difficile Saarland University Medical Center, Germany.
authors.forename: L
authors.initials: L
authors.lastname: von Müller
authors.affiliation: Institute of Medical Microbiology, University Medical Center Göttingen, Göttingen, Germany.
authors.forename: K
authors.initials: K
authors.lastname: Gunka
authors.affiliation: Institute of Medical Microbiology, University Medical Center Göttingen, Göttingen, Germany.
authors.forename: O
authors.initials: O
authors.lastname: Zimmermann
authors.affiliation: Institute of Medical Microbiology, University Medical Center Göttingen, Göttingen, Germany.
authors.forename: U
authors.initials: U
authors.lastname: Groß
keywords: Clostridium difficile; Tanzania; diarrhoea; immunocompromised; sub-Saharan