Clostridium difficile associated disease in Thailand

Over a twenty-six month period 383 fecal specimens from 269 diarrheal patients and 114 control patients were examined for Clostridium difficile and its cytotoxin. C. difficile was isolated from 13 (4.8%) of overall age group of diarrheal patients and from 3 (2.6%) of controls. Fecal cytotoxin was detected in 106 (52.5%) of 203 diarrheal patients and in 17 (22.4%) of 76 controls. Sixty-one percent of antibiotic-associated diarrheal patients (less than 3 years) and 51% of non-antibiotic associated diarrhea patients had fecal cytotoxin. Enteric pathogens other than C. difficile were detected in 0.7-7.4% of the patients studied. These data suggest that C. difficile associated disease may be frequently encountered in such a developing region studied. Routine diagnosis for C. difficile in diarrheal patients appears to be warranted.