Purpose: Clostridium difficile (C. difficile) is an important causative agent of nosocomial diarrhoea and has become a major worldwide public health concern. The current study was conducted to determine the prevalence of C. difficile infection (CDI) amongst patients with nosocomial diarrhoea in a large tertiary care hospital in Taif, Saudi Arabia, and to define molecular characteristics and antimicrobial sensitivity profiles of C. difficile strains isolated from those patients. Materials and Methods: Stool specimens were collected from 456 patients and were cultured for C. difficile isolation. The isolates were subjected to multiplex polymerase chain reaction (PCR) for detecting genes encoding the toxins (toxin A, toxin B and binary toxin [CDT]), genotyping by PCR ribotyping method and antimicrobial sensitivity testing using E test strips. Results: Seventy-four C. difficile strains were recovered, of which 44 (59.5%) were A⁺B⁺CDT⁻, 14 (18.9%) were A⁻B⁺CDT⁻, 4 (5.4%) were A⁺B⁺CDT⁺ and 12 (16.2%) were A⁻B⁻CDT⁻. Toxigenic strains, and hence CDI, were detected in 13.6% of the patients (62/456). Fourteen different ribotypes were distinguished amongst bacterial isolates, of which ribotypes 002, 001, 017, 014 and 020 were the most prevalent (20.3%, 18.9%, 18.9%, 9.5% and 8.1%, respectively). Four isolates (5.4%) belonged to ribotype 027. All bacterial isolates showed sensitivity to metronidazole, vancomycin and piperacillin-tazobactam. The isolates exhibited resistance to linezolid (2.7%), chloramphenicol (5.4%), rifampicin (13.5%), tetracycline (21.6%), moxifloxacin (48.6%), clindamycin (54%) and imipenem (83.8%). Multiple drug resistance was observed in 56.8% of the isolates. Conclusion: Further larger studies are required for an accurate understanding of CDI epidemiology in Saudi Arabia.


中文翻译：

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沙特阿拉伯塔伊夫一家三级医院艰难梭菌的患病率、毒素基因谱、基因型和抗生素敏感性。



目的：艰难梭菌（ C. difficile ）是院内腹泻的重要病原体，已成为全球主要的公共卫生问题。目前的研究旨在确定沙特阿拉伯塔伊夫一家大型三级护理医院院内腹泻患者中艰难梭菌感染 (CDI) 的患病率，并确定从艰难梭菌中分离出的艰难梭菌菌株的分子特征和抗菌敏感性特征。那些病人。材料和方法：从 456 名患者身上采集粪便标本，并进行培养以分离艰难梭菌。对分离株进行多重聚合酶链反应 (PCR) 检测编码毒素（毒素 A、毒素 B 和二元毒素 [CDT]）的基因，通过 PCR 核糖分型方法进行基因分型，并使用 E 试纸进行抗菌敏感性测试。结果：回收艰难梭菌74株，其中A ⁺ B ⁺ CDT ⁻ 44株（59.5%），A ⁻ B ⁺ CDT ⁻ 14株（18.9%），A ⁺ B+4株（5.4% ^） CDT ⁺和 12 (16.2%) 为 A ^– B ^– CDT ^– 。在 13.6% 的患者 (62/456) 中检测到产毒菌株，从而检测到 CDI。细菌分离株中有 14 种不同的核糖型，其中核糖型 002、001、017、014 和 020 是最常见的（分别为 20.3%、18.9%、18.9%、9.5% 和 8.1%）。 4 个分离株（5.4%）属于核糖型 027。所有细菌分离株均对甲硝唑、万古霉素和哌拉西林-他唑巴坦敏感。 分离株对利奈唑胺（2.7%）、氯霉素（5.4%）、利福平（13.5%）、四环素（21.6%）、莫西沙星（48.6%）、克林霉素（54%）和亚胺培南（83.8%）表现出耐药性。 56.8%的分离株出现多重耐药。结论：需要进一步进行更大规模的研究才能准确了解沙特阿拉伯的 CDI 流行病学。