Diagnostic deficiencies of infection among patients in a tertiary hospital in Saudi Arabia: A laboratory-based case series.

infection (CDI) has become a threatening public health problem in the developed world. In the kingdom of Saudi Arabia, prevalence of CDI is still unknown due to limited surveillance protocols and diagnostic resources. We used a two-step procedure to study and confirm cases. We also studied toxin profiles of these isolates. Stool samples were collected from symptomatic patients and clinically suspected of CDI for almost 12 months. Isolates were confirmed by culture method followed by sequencing. Multiplex PCR was performed for the identification of toxin A, toxin B and binary toxin genes and compared to Gene Expert results. Out of the 47 collected samples, 27 were successfully grown on culture media. 18 samples were confirmed as by both culture and sequencing. Interestingly, the rest of the isolates (9 species) belonged to different genera. Our results showed 95% of samples were positive for both toxin A and B () and all samples exhibited the toxin gene regulator . All samples were confirmed negative for the binary toxin gene and 11% of the isolates were positive for gene. Interestingly, one isolate harbored the binary toxin gene ( ) and tested negative for both toxins A and B. We believe that combining the standard culture method with molecular techniques can make the detection of more accurate.