Investigation of Clostridioides (Clostridium) difficile in patients with hospital-acquired diarrhea

Eyyüp Kaya; Candan Öztürk; Seda Tezcan Ülger; Hamide Kaya; Sebahat Aslan Tek

Makale detayları

Investigation of Clostridioides (Clostridium) difficile in patients with hospital-acquired diarrhea

Yazarlar:

Eyyüp Kaya | Candan Öztürk | Seda Tezcan Ülger | Hamide Kaya | Sebahat Aslan Tek

Yayıncı:

Mersin University

Ana Başlıklar:

Sağlık Kurumları Yönetimi

Dergi:

Mersin Üniversitesi Sağlık Bilimleri Dergisi Vol.16 Issue 3, pp.461-472

Belge Tipi:

Makale

Yayın Tarihi:

12/2023

Belge Dili:

Türkçe

Document ID (Org No.):

2001304719

pISSN:

1308-0830

Anahtar kelimeler:

Özet:

 Aim: Clostridioides difficile infection is a healthcare-associated infection and is an important source of mortality and morbidity, especially for hospitalized patients. In our study, we aimed to determine the incidence of C. difficile in hospital-acquired diarrhea by isolating C. difficile and investigating the presence of toxin in stool samples of hospitalized patients. Method: The study included 85 patients over two years of age who had loose or watery stools more than three times a day for at least two days and hospitalized in various wards at Mersin University Hospital between October 2020 and July 2021. Stool samples collected in sealed containers were analyzed for the presence of C. difficile toxin AB using the Epilisa Fecal C. difficile Toxin AB ELISA Kit Epitope Diagnostics, Inc. ABD within 24-48 hours. In addition, stool samples were cultured on C. difficile agar containing cycloserine, cefoxitin, amphotericin-B Biomerieux, Fransa, ChromID C. difficile agar Biomerieux, Fransa and 5 sheep blood Columbia agar Biomerieux, Fransa media. The media were incubated in an anaerobic environment at 37C for 48-72 hours and then evaluated. The colonies identified as C. difficile were inoculated on Schaedler Anaerobic Broth Oxoid, İngiltere and after 48-72 hours of anaerobic incubation, the presence of toxin was investigated by ELISA method. Results: ELISA toxin AB positivity was found to be 4.7 485 in our study. Six 7.1 C. difficile isolates were isolated in anaerobic culture and the presence of toxin was detected in three of them p1.000. The frequency of CDE in our patient population was determined to be 3.5 n3. When toxigenic culture was taken as the reference test, the sensitivity, specificity, positive predictive value and negative predictive value of ELISA Toxin AB test were determined as 100, 98.8, 75 and 100, respectively. Conclusion: Rational antibiotic use and appropriate infection control programs should be considered in the prevention of CDE, which is associated with antibiotic use and hospitalization.

 Aim: Clostridioides difficile infection is a healthcare-associated infection and is an important source of mortality and morbidity, especially for hospitalized patients. In our study, we aimed to determine the incidence of C. difficile in hospital-acquired diarrhea by isolating C. difficile and investigating the presence of toxin in stool samples of hospitalized patients. Method: The study included 85 patients over two years of age who had loose or watery stools more than three times a day for at least two days and hospitalized in various wards at Mersin University Hospital between October 2020 and July 2021. Stool samples collected in sealed containers were analyzed for the presence of C. difficile toxin AB using the Epilisa Fecal C. difficile Toxin AB ELISA Kit Epitope Diagnostics, Inc. ABD within 24-48 hours. In addition, stool samples were cultured on C. difficile agar containing cycloserine, cefoxitin, amphotericin-B Biomerieux, Fransa, ChromID C. difficile agar Biomerieux, Fransa and 5 sheep blood Columbia agar Biomerieux, Fransa media. The media were incubated in an anaerobic environment at 37C for 48-72 hours and then evaluated. The colonies identified as C. difficile were inoculated on Schaedler Anaerobic Broth Oxoid, İngiltere and after 48-72 hours of anaerobic incubation, the presence of toxin was investigated by ELISA method. Results: ELISA toxin AB positivity was found to be 4.7 485 in our study. Six 7.1 C. difficile isolates were isolated in anaerobic culture and the presence of toxin was detected in three of them p1.000. The frequency of CDE in our patient population was determined to be 3.5 n3. When toxigenic culture was taken as the reference test, the sensitivity, specificity, positive predictive value and negative predictive value of ELISA Toxin AB test were determined as 100, 98.8, 75 and 100, respectively. Conclusion: Rational antibiotic use and appropriate infection control programs should be considered in the prevention of CDE, which is associated with antibiotic use and hospitalization.

 Aim: Clostridioides difficile infection is a healthcare-associated infection and is an important source of mortality and morbidity, especially for hospitalized patients. In our study, we aimed to determine the incidence of C. difficile in hospital-acquired diarrhea by isolating C. difficile and investigating the presence of toxin in stool samples of hospitalized patients. Method: The study included 85 patients over two years of age who had loose or watery stools more than three times a day for at least two days and hospitalized in various wards at Mersin University Hospital between October 2020 and July 2021. Stool samples collected in sealed containers were analyzed for the presence of C. difficile toxin AB using the Epilisa Fecal C. difficile Toxin AB ELISA Kit Epitope Diagnostics, Inc. ABD within 24-48 hours. In addition, stool samples were cultured on C. difficile agar containing cycloserine, cefoxitin, amphotericin-B Biomerieux, Fransa, ChromID C. difficile agar Biomerieux, Fransa and 5 sheep blood Columbia agar Biomerieux, Fransa media. The media were incubated in an anaerobic environment at 37C for 48-72 hours and then evaluated. The colonies identified as C. difficile were inoculated on Schaedler Anaerobic Broth Oxoid, İngiltere and after 48-72 hours of anaerobic incubation, the presence of toxin was investigated by ELISA method. Results: ELISA toxin AB positivity was found to be 4.7 485 in our study. Six 7.1 C. difficile isolates were isolated in anaerobic culture and the presence of toxin was detected in three of them p1.000. The frequency of CDE in our patient population was determined to be 3.5 n3. When toxigenic culture was taken as the reference test, the sensitivity, specificity, positive predictive value and negative predictive value of ELISA Toxin AB test were determined as 100, 98.8, 75 and 100, respectively. Conclusion: Rational antibiotic use and appropriate infection control programs should be considered in the prevention of CDE, which is associated with antibiotic use and hospitalization.

 Amaç: Clostridioides difficile enfeksiyonu, sağlık hizmeti ile ilişkili bir enfeksiyon olup özellikle hastanede yatan hastalar için önemli mortalite ve morbidite kaynağıdır. Çalışmamızda; hastane kaynaklı ishallerde C. difficile insidansını belirlemek için yatan hastaların gaita örneklerinde C. difficile izolasyonu ve toksin varlığının araştırılması amaçlanmıştır. Yöntem: Çalışmaya, Ekim 2020-Temmuz 2021 tarihleri arasında Mersin Üniversitesi Hastanesinde çeşitli servislere yatırılan, en az iki gün boyunca günde üçten fazla gevşek veya sulu dışkılama yapan, iki yaş üzerinde 85 hasta dahil edilmiştir. Sızdırmaz kaplarda toplanan gaita örneklerinde, 24-48 saat içinde Epilisa Fecal C. difficile Toksin AB ELISA kiti Epitope Diagnostics, Inc. ABD kullanılarak C. difficile toksin AB varlığı araştırılmıştır. İlave olarak gaita örnekleri; sikloserin, sefoksitin, amfoterisin-B içeren C. difficile agar Biomerieux, Fransa, ChromID C. difficile agar Biomerieux, Fransa ve 5 koyun kanlı Columbia agar Biomerieux, Fransa besiyerlerine ekilmiştir. Besiyerleri 37Clik etüvde anaerop ortamda 48-72 saat inkübe edildikten sonra değerlendirilmiştir. C. difficile olarak tanımlanan kolonilerden Schaedler Anaerop buyyona Oxoid, İngiltere ekim yapılmış ve 48-72 saatlik anaerop inkübasyonun sonunda ELISA yöntemiyle toksin varlığı araştırılmıştır. Bulgular: Çalışmamızda ELISA toksin AB pozitifliği 4.7 485 olarak bulunmuştur. Anaerop kültürde üreyen altı 7.1 C. difficile izolatının üçünde toksin varlığı saptanmıştır p1.000. Hasta popülasyonumuzda CDE sıklığının 3.5 n3 olduğu belirlenmiştir. Toksijenik kültür referans test olarak alındığında, ELISA Toksin AB testinin duyarlılık, özgüllük, pozitif prediktif değer ve negatif prediktif değeri sırasıyla; 100, 98.8, 75 ve 100 olarak belirlenmiştir. Sonuç: Antibiyotik kullanımı ve hastane yatışı ile ilişkili olan CDEnun önlenmesinde akılcı antibiyotik kullanımı ve uygun enfeksiyon kontrol programlarının göz önünde bulundurulması gereklidir.

Makale detayları

Investigation of Clostridioides (Clostridium) difficile in patients with hospital-acquired diarrhea

Yazarlar:

Eyyüp Kaya | Candan Öztürk | Seda Tezcan Ülger | Hamide Kaya | Sebahat Aslan Tek

Yayıncı:

Mersin University

Ana Başlıklar:

Sağlık Kurumları Yönetimi

Dergi:

Mersin Üniversitesi Sağlık Bilimleri Dergisi Vol.16 Issue 3, pp.461-472

Belge Tipi:

Makale

Yayın Tarihi:

12/2023

Belge Dili:

Türkçe

Document ID (Org No.):

2001304719

pISSN:

1308-0830

Hospital-acquired

diarrhea

Clostridium difficile

toxin A/B

anaerobic cultureHastane kaynaklı

ishal

Clostridium difficile

toksin A/B

anaerobik kültür

Sayı

Makale detayları

Yazarlar: Eyyüp Kaya | Candan Öztürk | Seda Tezcan Ülger | Hamide Kaya | Sebahat Aslan Tek

Yayıncı: Mersin University

Ana Başlıklar: Sağlık Kurumları Yönetimi

Dergi: Mersin Üniversitesi Sağlık Bilimleri Dergisi Vol.16 Issue 3, pp.461-472

Belge Tipi: Makale

Yayın Tarihi: 12/2023

Belge Dili: Türkçe

Document ID (Org No.): 2001304719

pISSN: 1308-0830

Sayı

Yazarlar:

Eyyüp Kaya | Candan Öztürk | Seda Tezcan Ülger | Hamide Kaya | Sebahat Aslan Tek

Yayıncı:

Mersin University

Ana Başlıklar:

Sağlık Kurumları Yönetimi

Dergi:

Mersin Üniversitesi Sağlık Bilimleri Dergisi Vol.16 Issue 3, pp.461-472

Belge Tipi:

Makale

Yayın Tarihi:

12/2023

Belge Dili:

Türkçe

Document ID (Org No.):

2001304719

pISSN:

1308-0830