Ribotyping of Clostridium difficile isolates isolated from patients referred to Imam Reza hospital, Tabriz in 2018

Abstract

Clostridium difficile is a spore-forming strictly anaerobic microorganism which is the most common definable cause of hospital and antibiotic associated diarrhea (AAD). Clinical manifestations can range from simple diarrhea to pseudomembranous colitis. Due to the fact that Clostridium difficile associated diarrhea (CDAD) is a major problem in the hospital and community, it is important to identify the common ribotypes and source of infection by PCR-ribotyping. Method and materials: In this cross-sectional study, 160 fecal samples were collected from inpatients in different wards of Imam Reza hospitals in Tabriz, the northwest of Iran. Immuno-chromatographic assay for detection of toxins A and B of Clostridium difficile was used. The samples were cultured on a Columbia agar supplemented with 5% sheep blood and incubated in anaerobic conditions, at 37 °C for 5 days. The tpi, tcdA, and tcdB genes were identified using PCR assay. PCR ribotyping was performed on Clostridium difficile isolates. Results: Clostridium difficile was isolated from 23 (14.4%) out of 160 samples and only 19 (82.6%) of these isolates were toxigenic. The total isolates fell into the A+B+, A-B+ and A+B- strains were 12 (63.1%), 6 (31.6%) and 1 (5.3%) respectively. 4 isolates were A- B-. PCR ribotyping of 23 isolates showed that the samples were divided into two clusters. Some isolates had 99% similarity and other samples had different ribotyping patterns.