Clinical importance of Clostridium difficile finding in hospitalized patients

INTRODUCTION: Clostridium difficile infections predominatelly occur among hospitalized patients. The aim of this study was to evaluate the importance of finding the isolate of Clostridium difficile cultured from the stool of hospitalized patients. MATERIAL AND METHODS: Material consisted of 100 patients with at least one liquid stool samples and control group with form stool. Every patient spent minimum 48h in hospital before the sampling. The material was immediately cultured on mediums for isolation of enteric pathogens, and on selective CCFA medium (Biomedics) for Clostridium difficile in anaerobic condition. Diagnosis of Clostridium difficile toxin in stool samples was achieved by ELISA-RIDASCREEN Clostridium difficile Toxin A/B test (R-Biopharm). RESULTS: One-hundred forty one stool samples of patients in Clinical Centre Nis were cultivated and examined for C. difficile. The bacteria was isolated in seven patients from the clinical group. In four (57.14%) patients, the presence of C difficile toxin in stool was established The bacteria was diagnosed from the stool samples of five patients from the control group, but the toxin was not found in their stool samples. DISCUSSION: The results performed at the Institute for Public Health Nis are in accordance with previously published results that all patients with positive findings of Clostridium difficile toxin in stool samples were on antibiotic treatment longer than 14 days. By analysing the patient's stay in hospital and duration of antibiotic treatment, we observed the statistically significant difference in findings between the patients with CDAD and the patients from the control group with positive bacteria. CONCLUSION: The study confirms the importance of finding Clostridium difficile associated disease in four (4%) hospitalized patients.