AIM

This study was designed to investigate the prevalence of , its toxin-producing genes, and antibiotic resistance patterns in diarrheal samples from hospitalized patients in Hamadan, Iran.

BACKGROUND

Today, concerns over infection (CDI) have significantly increased due to reduced susceptibility to antibiotics used for CDI treatment. Toxins produced by strains are associated with disease severity and outcome.

METHODS

In this cross-sectional study, a total of 130 diarrheal samples of patients admitted to different wards of three hospitals in Hamadan from November 2018 to September 2019 were collected. isolates were identified by culture on CCFA and PCR (Polymerase chain reaction). The presence of toxin-encoding genes ( and ) and binary toxin genes ( and ) was analyzed by PCR. Resistance of the isolates to metronidazole, vancomycin and clindamycin antibiotics was determined using agar dilution method.

RESULTS

Out of 130 diarrheal samples from hospitalized patients, 16 (12.3%) isolates were obtained. PCR results were positive for two toxin-producing genes, A and , in all (100%) isolates, and the binary toxin genes A and were detected in 6 (37.5%) and 8 (50%) isolates, respectively. The results of antibiotic susceptibility testing showed resistance to metronidazole, vancomycin, and clindamycin in 3 (18.7%), 3 (18.7%), and 2 (12.5%) isolates, respectively, and all isolates were resistant to rifampicin.

CONCLUSION

The results of this study showed toxigenic with profile is a major cause of nosocomial diarrhea in Hamadan, and clinical laboratories should routinely perform diagnostic testing on diarrheal specimens of hospitalized patients. Resistance to conventional antibiotic therapy against should be considered as a warning to prevent irrational administration of antibiotics.