Kullin Brian R, Reid Sharon, Abratt Valerie
Department of Molecular and Cell Biology, Faculty of Science, University of Cape Town, Cape Town, South Africa.
Afr J Lab Med. 2018 Dec 6;7(2):846. doi: 10.4102/ajlm.v7i2.846. eCollection 2018.
Diarrhoea due to infection (CDI) poses a significant burden on healthcare systems around the world. However, there are few reports on the current status of the disease in sub-Saharan Africa.
This study examined the occurrence of CDI in a South African population of tuberculosis patients, as well as the molecular epidemiology and antibiotic susceptibility profiles of strains responsible for disease.
Toxigenic in patients with suspected CDI attending two specialist tuberculosis hospitals in the Cape Town area were detected using a PCR-based diagnostic assay (Xpert ). strains isolated from PCR-positive specimens were characterised by ribotyping, multilocus variable-number tandem-repeat analysis and antibiotic susceptibility testing.
The period prevalence of CDI was approximately 70.07 cases per 1000 patient admissions. Strains belonging to ribotype 017 (RT017) made up over 95% of the patient isolates and all of them were multi-drug resistant. Multilocus variable-number tandem-repeat analysis revealed several clusters of highly related RT017 strains present in tuberculosis patients in several wards at each hospital.
Tuberculosis patients represent a population that may be at an increased risk of developing CDI and, in addition, may constitute a multi-drug resistant reservoir of this bacterium. This warrants further investigation and surveillance of the disease in this patient group and other high-risk patient groups in sub-Saharan Africa.
感染性腹泻（CDI）给全球医疗系统带来了沉重负担。然而，关于撒哈拉以南非洲地区该疾病现状的报道较少。
本研究调查了南非结核病患者群体中CDI的发生情况，以及引起该疾病的菌株的分子流行病学和抗生素敏感性概况。
使用基于PCR的诊断检测方法（Xpert）对开普敦地区两家专科结核病医院疑似CDI患者的产毒菌株进行检测。从PCR阳性标本中分离出的菌株通过核糖体分型、多位点可变数目串联重复分析和抗生素敏感性测试进行鉴定。
CDI的期间患病率约为每1000例患者入院中有70.07例。属于核糖体分型017（RT017）的菌株占患者分离株的95%以上，且所有菌株均耐多药。多位点可变数目串联重复分析显示，每家医院的多个病房中的结核病患者中存在几簇高度相关的RT017菌株。
结核病患者可能是发生CDI风险增加的人群，此外，可能构成该细菌的耐多药储存库。这需要对该患者群体以及撒哈拉以南非洲其他高危患者群体中的该疾病进行进一步调查和监测。
