International E-publication: Publish Projects, Dissertation, Theses, Books, Souvenir, Conference Proceeding with ISBN.  International E-Bulletin: Information/News regarding: Academics and Research

Study of Clostridium difficile in South Gujarat region of India

Author Affiliations

  • 1Department of Microbiology, Shree Ramkrishna Institute of Computer Education and Applied Sciences, Behind P. T. Science College, Opposite Chowpati, Athawalines, Surat-395 001. Gujarat, INDIA

Res. J. Recent Sci., Volume 3, Issue (IVC-2014), Pages 34-41,(2014)

Abstract

Toxin-producing Clostridium difficile strains is a common cause of diarrhoea today. Clostridium difficile presently has been identified as a causative agent of a spectrum of diseases referred to as Clostridium difficile Infections (CDI). CDI can establish as self-limiting antibiotic-associated diarrhoea (AAD) and antibiotic-associated colitis (AAC) to severe and life threatening forms like; pseudomembranous colitis (PMC) and toxic megacolon. Indian studies have reported Clostridium difficile-associated Diarrhoea (CDAD) prevalence rates ranging from 7.1% to 26.6% and its incidence varies considerably from place to place. The present work was conducted with the objective to study Clostridium difficile and its prevalence in the South Gujarat Region of the Gujarat state of India. Alcohol Shock treatment was given to the stool sample, followed by enrichment of spores by inoculating an RCM broth (added with 0.1% sodium taurocholate). After 48 hr., subculture was made on CCFA medium. Plates were incubated anaerobically for 48hrs. The C. difficile isolates were identified by colonial characteristic, fluorescence under UV light and positive Latex Agglutination test. The isolates were further characterized by gram reaction for cellular morphology, spore staining and various biochemical tests as described in Bergey's Manual of Systematic Bacteriology. Among 271 clinical stool investigated, 176 were of male and 95 were of female patients. In total 16 isolates have been obtained from total of 271 clinical samples i.e. the isolation rate is 5.9% during six month. Among this C. difficile has been isolated from 10 males (62.5%) and 6 females (37.5%). A case of PMC has also been reported in present study.

References

  1. Rotimi V.O., Wafaa Y.J., Eiman M.M., Brazier J.S., Johny M. and Duerden B.I., Prevalent PCR ribotypes of clinical and environmental strains of Clostridium difficile isolated from intensive-therapy unit patients in Kuwait, J of Med Microbiol., 52, 705–709 (2003)
  2. Khanna S. and Pardi D.S., Clostridium difficile infection: management strategies for a difficult disease, Ther Adv Gastroenterol., 7(2), 72–86 (2014) 3. Lessa F.C., Gould C.V., and McDonald L.C., Current Status of Clostridium difficile Infection Epidemiology, Clin Infect Dis., 55(S2), S65–70 (2012)
  3. Lessa F.C., Gould C.V., and McDonald L.C., Current Status of Clostridium difficile Infection Epidemiology, Clin Infect Dis., 55(S2), S65–70 (2012)
  4. Eastwood K., Else P., Charlett A. and Wilcox M., Comparison of nine commercially available Clostridium difficile toxin detection assays, a realtime PCR assay for C. difficile tcdB, and a glutamate dehydrogenase detection assay to cytotoxin testing and cytotoxigenic culture methods, J Clin Microbiol., 47, 3211–17 (2009)
  5. McDonald L.C., Killgore G.E., Thompson A., Owens R.C., Kazkova S.V., Sambol S.P., Johnson S. and Gerding D.N., An epidemic, toxin gene-variant strain of Clostridium difficile, N Engl J Med., 353(23), 2433–41 (2005)
  6. Tenover F.C., Novak W.S. and Woods C.W. et al., Impact of strain type on detection of toxigenic Clostridium difficile: comparison of molecular diagnostic and enzyme immunoassay approaches, J Clin Microbiol., 48, 3719–24 (2010)
  7. Hall I.C., O’Toole E. Intestinal flora in newborn infants with a description of a new pathogenic anaerobe, Bacillus difficile, Am J Dis Child., 49, 390–402 (1935)
  8. Bartlett J.G., Chang T.W., Gurwith M., Gorbach S.L. and Onderdonk A.B., Antibiotic-associated pseudomembranous colitis due to toxin producing clostridia, N Engl J Med., 298, 531–4 (1978)
  9. Surawicz C.M., Brandt L.J., Binion D.G., Ananthakrishnan A.N., Curry S.R., Gilligan P.H., McFarland L.V., Mellow M. and Zuckerbraun B.S., Guidelines for Diagnosis, Treatment, and Prevention of Clostridium difficile Infections, Am J Gastroenterol., 108, 478–498 ( 2013)
  10. Fekety R., Guidelines for the diagnosis and management of Clostridium difficile-associated diarrhea and colitis American College of Gastroenterology, Practice Parameters Committee, Am J Gastroenterol., 92, 739–50 (1997)
  11. Modena S., Bearelly D., Swartz K. and Friedenberg F.K., Clostridium difficile among hospitalized patients receiving antibiotics: a case– control study, Infect Control Hosp Epidemiol., 26, 685–90 (2005)
  12. Vaishnavi C., Clostridium difficile infection: clinical spectrum and approach to management, Indian J Gastroenterol., 30(6), 245–254 (2011)
  13. Kuijper E.J., Coignard B. and Tüll P., ESCMID Study Group for Clostridium difficile; EU Member States; European Centre for Disease Prevention and Control. Emergence of Clostridium difficile-associated disease in North America and Europe, Clin Microbiol Infect.,12(Suppl 6), 2–18 (2006)
  14. Kelly C.P. and LaMont J.T., Clostridium difficile—more difficult than ever, N Engl J Med., 359, 1932–40 (2008)
  15. Clements A.C., Magalhaes R.J., Tatem A.J., Paterson D.L. and Riley T.V., Clostridium difficile PCR ribotype 027: assessing the risks of further worldwide spread, Lancet Infect Dis., 10(6), 395–404 (2010)
  16. Paola M., Hypervirulent antibiotic resistant Clostridium difficile in Europe, Microb Ecol Health D., 20, 210-212 (2008)
  17. Scroeder M.S., Clostridium difficile associated Diarrhea, Am fam physician., 71, 921-928 (2005)
  18. Collins A. Deirdre, Peter M. Hawkey and Thomas V. Riley, Epidemiology of Clostridium difficile infection in Asia, Antimicrob Resist and Infect Control., 2(21), 9 pages (2013)
  19. Joshy L., Chaudhry R., Kumar L. and Dhawan B., Detection and characterization of Clostridium difficile from patients with antibiotic associated diarrhea in a tertiary care hospital in North India, J of Med Microbiol., 125, 1657-1659 (2009)
  20. Pawar D., Bhandari P. and Allenby K., Clostridium difficileAssociated Diarrhea: A review, IMG., 12, 481-94 (2011)
  21. Ayyagari A., Sharma P., Venkateswarlu, Mehta S., Agarwal K.C., Prevalence of Clostridium difficile in pseudomembranous and antibiotic-associated colitis in north India, J Diarrhoeal Dis Res., 4(3), 157–60 (1986)
  22. Chaudhry R., Joshy L., Kumar L. and Dhawan B., Changing pattern of Clostridium difficile associated diarrhoea in a tertiary care hospital: a 5 year retrospective study, Indian J Med Res., 127, 377-82 (2008)
  23. Dutta P., Niyogi S.K., Mitra U., Rasardy R., Bhattacharya M.K. and Chakraborty S., Clostridium difficile in antibiotic associated pediatric diarrhea, Indian Pediatr., 31, 121-6 (1994)
  24. Gupta U. and Yadav R.N., Clostridium difficile in hospital patients, Indian J Med Res., 82, 398–401 (1985)
  25. Katyal R., Vaishnavi C. and Singh K., Faecal excretion of brush border membrane enzymes in patients with clostridium difficile diarrhoea, Indian J Med Microbiol., 20, 178–82 (2002)
  26. Vaishnavi C., Kochhar R., Bhasin D.K., Thapa B.R. and Singh K., Detection of Clostridium difficile toxin by an indigenously developed latex agglutination assay, Trop Gastroenterol., 20, 33-5 (1999)
  27. Vaishnavi C., Clinical spectrum and pathogenesis ofClostridium difficile associated diseases, Indian J Med Res.,131, 487-499 (2010)
  28. Niyogi S.K., Bhattacharya S.K., Dutta P., Naik T.N. and Sen D., Prevalence of Clostridium difficile in hospitalised patients with acute diarrhoea in Calcutta, J Diarrhoeal Dis Res., 9, 16-9 (1991)
  29. Kochhar R., Ayyagari A., Goenka M.K., Dhali G.K., Aggarwal R. and Mehta S.K., Role of infectious agents in exacerbation of ulcerative colitis in India: A study of Clostridium difficile, J Clin Gastroenterol., 16, 26-30 (1993)
  30. Cohen S.H., Gerding D.N., Johnson S., Kelly C.P., Loo V.G., McDonald L.C., Pepin J. and Wilcox M.H., Clinical practice guidelines for Clostridium difficile infection in adults: 2010 update by the Society for Healthcare Epidemiology of America (SHEA) and the Infectious Diseases Society of America (IDSA), Infect Control Hosp Epidemiol.,31, 431-55 (2010)
  31. Reddymasu S., Sheth A. and Banks D.E., Is fecal leukocyte test a good predictor of Clostridium difficile associated diarrhea?, Ann Clin Microbiol Antimicrob., 5, 3 (2006)
  32. Carroll K., Tests for the diagnosis of Clostridium difficile infection: the next generation, Anaerobe., 17, 170–174 (2011)
  33. Sloan L., Duresko B., Gustafson D. and Rosenblatt J., Comparison of real-time PCR for detection of the tcdC gene with four toxin immunoassays and culture in diagnosis of Clostridium difficile infection, J Clin Microbiol., 46, 1996– 2001 (2008)
  34. Bergey's Manual of Systemetic Bacteriology, 2nd Edition., 3, 771-772 and 748 (2001)
  35. Soman R. and Sunaval A., Clostridium difficile Infection- Is it Coming at us, JAPI., 60, 9-10 (2012)
  36. Dhawan B., Chaudhry R. and Sharma N., Incidence of Clostridium difficile infection: a prospective study in an Indian hospital, J Hosp Infect., 43, 275-80 (1999)
  37. Niyogi S.K., Dutta P., Dutta D., Mitra U. and Sikdar S. Clostridium difficile and its cytotoxin in hospitalized children with acute diarrhea, Indian Paediatr., 28, 1129-32 (1991)
  38. Ingle M., Deshmukh A., Desai D., Abraham P., Joshi A., Rodrigues C., Mankeshwar R., Prevalence and clinical course of Clostridium difficile infection in a tertiary-care hospital: a retrospective analysis, Indian J Gastroenterol., 30, 89-93 (2011)
  39. Kaneria M.V., Paul S., Incidence of Clostridium Difficile Associated Diarrhoea in a Tertiary Care Hospital., JAPI, 60, 26-28 (2012)
  40. Vaishnavi C., Bhasin D.K. and Singh K., Faecal lactoferrin assay -as a cost effective tool for intestinal inflammation, Am J Gastroenterol., 95, 3002-3003 (2000)
  41. Vishwanath S., Singhal A., D’Souza A., Mukhopadhyay C., Varma M. and Bairy I., Clostridium difficile Infection at a Tertiary Care Hospital in South India, JAPI., 61, 30-32 (2013)
  42. Gogate A, De A, Nanivadekar R, Mathur M., Saraswathi K., Jog A. and Kulkarni M.V., Diagnostic role of stool culture and toxin detection in antibiotic associated diarrhoea due to Clostridium difficile in children, Indian J Med Res., 122, 518–24 (2005)
  43. Vaishnavi C., Thapa B.R., Thennarasu K. and Singh K., Faecal lactoferrin assay as an adjunct to Clostridium difficile diarrhea, Indian J Pathol Microbiol., 45, 69-74 (2002)
  44. Al-Eidan F.A., McElnay J.C., Scott M.G. and Kearney M.P., Clostridium difficile associated diarrhoea in hospitalized patients, J Clin Pharm Ther., 25, 101-9 (2000) 45. Bartlett J.G., Antibiotic-associated diarrhea, N Engl J Med., 346, 334–9 (2002)
  45. Bartlett J.G., Antibiotic-associated diarrhea, N Engl J Med.,346, 334–9 (2002)
  46. Mylonakis E., Ryan E.T. and Calderwood S.B., Clostridium difficile associated diarrhea: a review, Arch Intern Med., 161, 525–33 (2001) 47. Kelly C.P. and LaMont J.T., Clostridium difficile infection, Annu Rev Med., 49, 375–90 (1998)
  47. Kelly C.P. and LaMont J.T., Clostridium difficile infection, Annu Rev Med., 49, 375–90 (1998)
  48. O'Farrell S., Wilks M., Nash J.Q. and Tabaqchali S., A selective enrichment broth for the isolation of Clostridium difficile, Technical Method, JCP., 37(1), 98-99 (1984)
  49. Wilson K.H., Kennedy M.J. and Fekety F.R., Use of sodium taurocholate to enhance spore recovery on a medium selective for Clostridium difficile, J of Clin Microbiol., 15(3), 443-446 (1982)
  50. Brazier J.S., The diagnosis of Clostridium difficileassociated disease, J of Antimicrob Chemother., 41, Suppl. C, 29–40 (1998)