Vishwanath Shashidhar, Singhal Arpita, D'Souza Annet, Mukhopadhyay Chiranjay, Varma Muralidhar, Bairy Indira
J Assoc Physicians India. 2013 Nov;61(11):804-6.
The objective of this study was to detect C. difficile in patients presenting with Antibiotic Associated Diarrhoea.
Stool samples from twenty-five patients collected over a period of four months were processed for C. difficile by culture and the isolates were identified following standard methods. C. difficile toxins A and B and C. perfringens enterotoxin were detected by ELISA performed directly on stool specimens.
Four patients (16%) were found positive for C. difficile infection. All patients with C. difficile infection received prior treatment with third-generation cephalosporins or beta-lactam/beta-lactamase inhibitor antibiotics. C. perfringens enterotoxin was found in two (8%) patients. Severe colitis was seen in one (25%) of the four patients who had co-infection with C. difficile and C. perfringens.
This study demonstrated a significant occurrence of C. difficile infection in this hospital population. There is a need to further evaluate the role of C. perfringens in causing antibiotic associated diarrhoea. Good clinical and laboratory studies to generate local epidemiological data are essential to increase awareness among the treating clinicians about C. difficile infection. Also limited and rational use of broad spectrum antibiotics is recommended.
本研究的目的是检测出现抗生素相关性腹泻的患者中的艰难梭菌。
在四个月期间收集的25名患者的粪便样本通过培养进行艰难梭菌检测，并按照标准方法鉴定分离株。直接对粪便标本进行ELISA检测艰难梭菌毒素A和B以及产气荚膜梭菌肠毒素。
4名患者（16%）被发现艰难梭菌感染呈阳性。所有艰难梭菌感染患者之前均接受过第三代头孢菌素或β-内酰胺/β-内酰胺酶抑制剂抗生素治疗。在2名（8%）患者中发现了产气荚膜梭菌肠毒素。在4名同时感染艰难梭菌和产气荚膜梭菌的患者中，有1名（25%）出现了严重结肠炎。
本研究表明该医院人群中艰难梭菌感染发生率较高。有必要进一步评估产气荚膜梭菌在引起抗生素相关性腹泻中的作用。开展良好的临床和实验室研究以生成当地流行病学数据对于提高治疗临床医生对艰难梭菌感染的认识至关重要。此外，建议限制并合理使用广谱抗生素。
