Clostridium difficile associated disease in Thailand.

Area of Science:

• Medical Microbiology
• Infectious Diseases
• Gastroenterology

Background:

• Clostridium difficile is a significant cause of infectious diarrhea.
• Understanding the prevalence of C. difficile in developing regions is crucial for public health.
• Diarrheal diseases pose a substantial burden in resource-limited settings.

Purpose of the Study:

• To investigate the prevalence of Clostridium difficile and its cytotoxin in diarrheal patients and controls in a developing region.
• To assess the association between C. difficile, cytotoxin, and diarrhea, including antibiotic-associated cases.
• To determine the etiological role of C. difficile in comparison to other enteric pathogens.

Main Methods:

• Analysis of 383 fecal specimens from 269 diarrheal patients and 114 controls over 26 months.
• Isolation of Clostridium difficile using standard microbiological techniques.
• Detection of fecal cytotoxin using appropriate assays.
• Identification of other enteric pathogens.

Main Results:

• C. difficile was isolated from 4.8% of diarrheal patients and 2.6% of controls.
• Fecal cytotoxin was detected in 52.5% of diarrheal patients and 22.4% of controls.
• Cytotoxin was present in 61% of antibiotic-associated diarrhea cases and 51% of non-antibiotic associated cases.

Conclusions:

• Clostridium difficile-associated disease is frequently encountered in the studied developing region.
• The high prevalence of fecal cytotoxin in diarrheal patients underscores the clinical significance of C. difficile.
• Routine diagnostic testing for C. difficile in patients with diarrhea is warranted in this setting.