Abstract:

Objective To analyze the clinical characteristics of Clostridium difficile (C.difficile) infection for hospitalized patients with diarrhea in Ruijin Hospital, Shanghai Jiao Tong University School of Medicine. Methods A total of 706 unformed stool samples of hospitalized patients with diarrhea from November 2013 to February 2014 were collected. The anaerobic culture, latex agglutination test, and glutamate dehydrogenase gene (gluD) amplification were performed for identification of C.difficile strains. The DNA of strains was detected by the polymerase chain reaction (PCR) for the toxin A gene (tcdA) and toxin B gene (tcdB), and toxin types of the strains were analyzed. Clinical symptoms and medications of patients were analyzed based on their medical history. Results Among 706 samples, 34 C.difficile strains (4.82%) from 30 hospitalized patients were isolated. The C.difficile infection of 23 patients was nosocomial infection (76.67%) and they all had used one or more antibiotics, including cephalosporins, carbopenems, quinolones, etc. The toxin detection by the PCR showed that among 34 C.difficile strains, the toxin type of 21 strains were A+B+ type (61.76%); 12 strains were A-B+ type (35.30%); and only 1 strain was A-B- type (2.94%). Conclusion The C.difficile infection of most patients with diarrhea in Ruijin Hospital is nosocomial infection. The toxin type of strains is mainly A+B+ type. The use of antibiotics is an important factor of C.difficile infection.

Key words: Clostridium difficile, diarrhea, toxin, clinical characteristics