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Original ArticleOpen Access
Detection of Clostridium difficile Toxin A and B Genes from Stool Samples of Thai Diarrheal Patients by Polymerase Chain Reaction Technique
Wongwanich S 
,
Rugdeekha S ,
Pongpech P ,
Dhiraputra C
,
Rugdeekha S ,
Pongpech P ,
Dhiraputra C SIRIPORN RUGDEEKHA, MSc*,
CHERTSAK DHIRAPUTRA, MD, BSc***
The prevalence of
Clostridium difficile
isolated from stools of Thai adult patients with sus-
pected antibiotic-associated diarrhea (AAD) was 18.64 per cent.
The recovery rate of toxin genes
(tctiA
and
tcdB)
by polymerase chain reaction (PCR) from
stool samples yielded almost the same compared to the recovery rate of the toxin detection by enzyme
immunoassay (EIA), which were 44.9 per cent and 46.7 per cent, respectively. Correlation of toxin gene
detection by PCR and toxin detection by EIA was 90.6 per cent. All but one stool sample, the
tcdA
gene
was detected together with the
tcdB
gene. Both genes were always detected together from
tax
gene-
positive strains.
Although, there were some discrepancy results for certain samples, the direct PCR-based-
detection of
C.
difficile tax
genes in stool samples seems to be the appropriate method for the diag-
nosis of
C.
difficile
diarrhea. The PCR assay should be a recommended technique to be used routinely
in laboratories. Further optimization of the technique to increase the sensitivity of the PCR assays is
still needed.
However, a quantitative isolation of the organism from stools of suspected antibiotic-asso-
ciated diarrhea (AAD) or antibiotic-associated colitis (AAC) patients may give some evidence for clini-
cians in hospitals who cannot perform PCR-based or EIA-based techniques, since 48.6 per cent of the
isolates were demonstrated as toxigenic strains.
Key word :
Clostridium difficile,
Diarrhea, Polymerase Chain Reaction
CHERTSAK DHIRAPUTRA, MD, BSc***
The prevalence of
Clostridium difficile
isolated from stools of Thai adult patients with sus-
pected antibiotic-associated diarrhea (AAD) was 18.64 per cent.
The recovery rate of toxin genes
(tctiA
and
tcdB)
by polymerase chain reaction (PCR) from
stool samples yielded almost the same compared to the recovery rate of the toxin detection by enzyme
immunoassay (EIA), which were 44.9 per cent and 46.7 per cent, respectively. Correlation of toxin gene
detection by PCR and toxin detection by EIA was 90.6 per cent. All but one stool sample, the
tcdA
gene
was detected together with the
tcdB
gene. Both genes were always detected together from
tax
gene-
positive strains.
Although, there were some discrepancy results for certain samples, the direct PCR-based-
detection of
C.
difficile tax
genes in stool samples seems to be the appropriate method for the diag-
nosis of
C.
difficile
diarrhea. The PCR assay should be a recommended technique to be used routinely
in laboratories. Further optimization of the technique to increase the sensitivity of the PCR assays is
still needed.
However, a quantitative isolation of the organism from stools of suspected antibiotic-asso-
ciated diarrhea (AAD) or antibiotic-associated colitis (AAC) patients may give some evidence for clini-
cians in hospitals who cannot perform PCR-based or EIA-based techniques, since 48.6 per cent of the
isolates were demonstrated as toxigenic strains.
Key word :
Clostridium difficile,
Diarrhea, Polymerase Chain Reaction
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