Infect Chemother.  2003 Oct;35(5):241-248.

Diagnosis of Antibiotic-Associated Diarrhea and Pseudomembranous Colitis by Direct Detection of Clostridium difficile Toxin B Gene

• Hong YR
• Jeong SH
• Kim KB
• Lee SH
• Choi KH
• Park SJ
• Park M
• Jeon BC

Abstract

BACKGROUND: Clostridium difficile is the major cause of antibiotic-associated diarrhea (AAD) and pseudomembranous colitis (PMC). This study was designed to investigate predisposing factors of AAD or PMC and to evaluate the efficiency of nested PCR assay for direct detection of toxin B gene in the treatment and prognosis of these diseases.
METHODS
From January to December, 2002, stool specimens from 142 patients in Kosin Medical Center, Busan, were tested for the detection of toxigenic C. difficile strains. Toxin B gene in C. difficile was detected by nested PCR. And chart review was performed to investigate the antibiotics or anticancer drug history, clinical symptoms, treatment regimens, and prognosis.
RESULTS
Among 142 stool specimens, 56 specimens showed positive for the toxin B gene in C. difficile strains by PCR. Forty two percents (47/113) of stool specimens from patients with AAD and all of specimens from eight patiens with PMC were C. difficile toxin B gene positive. Administration of antibiotics or anticancer drugs was stopped in 92.7% of toxin B gene-positive cases, but those were stopped in only 48.5% of toxin B gene-negative cases. The cure rate was higher in positive cases (82%) than negative ones (71%).
CONCLUSION
It is concluded that nested PCR assay for the direct detection of C. difficile toxin B gene was helpful in rapid diagnosis and treatment of AAD or PMC.

Keyword

Clostridium difficile; nested PCR; antibiotic-associated diarrhea; pseudomembranous colitis

MeSH Terms

Anti-Bacterial Agents
Busan
Causality
Clostridium difficile*
Clostridium*
Diagnosis*
Diarrhea*
Enterocolitis, Pseudomembranous*
Humans
Polymerase Chain Reaction
Prognosis
Anti-Bacterial Agents