Prevalence of Clostridium difficile toxinotypes in infected patients at a tertiary care center in Lebanon

  • Romy Moukhaiber Faculty of Medicine, American University of Beirut and Medical Center, Beirut, Lebanon
  • George F Araj Faculty of Medicine, American University of Beirut and Medical Center, Beirut, Lebanon
  • Kohar Annie B Kissoyan Faculty of Medicine, American University of Beirut and Medical Center, Beirut, Lebanon
  • Katia A Cheaito Faculty of Medicine, American University of Beirut and Medical Center, Beirut, Lebanon
  • Ghassan M Matar Faculty of Medicine, American University of Beirut and Medical Center, Beirut, Lebanon
Keywords: Clostridium difficile, toxinotyping, tcdA, tcdB, RFLP

Abstract

Introduction: Due to the increase in the incidence of Clostridium difficile associated diseases at a tertiary care center in Lebanon, this study was undertaken to determine the prevalent C. difficile toxinotypes.

Methodology: The immunocard method was used to test for toxins A and B in 88 collected stool samples, followed with API 20A to confirm for C. difficile. PCR amplification of the triose phosphate isomerase (tpi) gene, the toxin encoding genes tcdA, and tcdB, followed by toxinotyping, were performed on recovered isolates and stool specimens.

Results: Out of the 88 stool samples obtained, 30 (65.2%) were Immunocard positive, culture and or tpi positive for C. difficile. Of the 30 isolates, 4 were PCR negative for the tcdA and tcdB genes (A-B-), and 26 were PCR positive for the tcdA and / or tcdB genes with 4 being A+B+, 1 A+B-, and 21 A-B+. The results of toxinotyping showed that 2 isolates belonged to toxinotype 0, 4 to toxinotype XI, 2 to toxinotype XII, 1 to toxinotype XVI, 1(A+B-) and twenty (A-B+) designated as toxinotype 0-like. C. difficile was detected in 65.2% of patients' stools with prevalence of toxinotype 0-like.

Conclusion: Identification of toxinotypes of C. difficile is important to determine the virulence potential of strains and control their spread.

Published
2015-07-30
How to Cite
1.
Moukhaiber R, Araj GF, Kissoyan KAB, Cheaito KA, Matar GM (2015) Prevalence of Clostridium difficile toxinotypes in infected patients at a tertiary care center in Lebanon. J Infect Dev Ctries 9:732-735. doi: 10.3855/jidc.6585
Section
Original Articles