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- Title
The prevalence and characteristics of Non-toxigenic Clostridioides difficile among patients with diarrhea.
- Authors
Cheon Hoo Jeon; Si-ho Kim; Yu Mi Wi
- Abstract
배경: Nontoxigenic C. difficile (NTCD) strains are usually not considered to be associated with symptomatic infection. Gastrointestinal NTCD colonization has been shown to prevent C. difficile infection (CDI) with exposure to a toxigenic strain. Herein, we investigated the prevalence and characteristics of NCTD among patients with diarrhea. 방법: Between July 2017 and June 2018, 1,182 unduplicated specimens were collected from diarrheic patients. Stool specimens were cultured anaerobically on C. difficile selective media and all identified C. difficile isolates were confirmed by 16s rRNA sequencing using extracted DNA. PCR for the tcdA, tcdB, cdtA, and cdtB genes and the commercial C. difficile toxin A & B EIA (RIDASCREEN Clostridium difficile Toxin A/B, R-Biopharm AG, Darmstadt, Germany) were performed in C. difficile isolates. 결과: Among the 1,182 stool specimens collected, 236 (18.5 %) were identified as growing C. difficile. Among the 236 anaerobically cultured isolates, PCR-positive/toxin-positive strains were 107 cases and PCR-positive/toxin-negative strains were 83 cases. A total of 46 strains were identified as NTCD strains. Multivariate analysis showed underlying diabetes (OR = 4.28, 95% CI 1.63-11.26; P = 0.003) and previous use of glycopeptide (OR = 4.60, 95% CI 1.32-16.10; P = 0.017) were independently associated with the NCTD group whilst proton pump inhibitor use at diagnosis (OR = 4.01, 95% CI 1.49-10.74; P = 0.006) was prevalent in the toxigenic group. Although there was not statistical significance, CDI development following 90 days tended to be lower in the NTCD group (2.2%) compared to the toxigenic group (8.4%). 결론: High rates of NTCD strains in the diarrheic patients was noted. Underlying diabetes and previous use of glycopeptide was associated with NTCD stains while PPI use was associated with toxigenic strains. Further research is needed on the protective effect of NTCD strains to prevent CDI.
- Subjects
DARMSTADT (Germany); CLOSTRIDIOIDES difficile; CLOSTRIDIUM; PROTON pump inhibitors; DIARRHEA
- Publication
Infection & Chemotherapy, 2022, Vol 54, p372
- ISSN
2093-2340
- Publication type
Article