Clostridium difficile has become the most common cause of hospital acquired diarrhea after antibiotic treatment. The aim of this study was to determine the frequency of C. difficile associated diarrhea among hematology/oncology ward patients and to characterize isolated strains. Twenty three toxigenic and thirteen non-toxigenic strains were detected among fecal isolates. Antibiotic susceptibility testing to erythromycin and clindamycin demonstrated a high degree of resistance (MIC > 256 ug/ml) to both antibiotics in 9 out of 13 nontoxigenic C. difficle strains. Out of 7 patients with maximal frequency of diarrhea (10 empties/day) in 4 cases non-toxigenic strains of C. difficile were isolated. In these cases duration of diarrhea was longer in time than in cases of diarrhea caused by toxigenic strains. Further investigation with a larger patient population is necessary to better understand the role that non-toxigenic C. difficile strains play in disease development.
Anand A. and A.E. Glatt. 1993. C. difficile infection associated with antineoplastic chemotherapy: a review. Clin. Infect. Dis. 17: 109-113.
Berild D., SL. Smaabrekke, D.S. Halvorsen, M. Lelek, E.M. Stahlsberg and S.H. Ringertz. 2003. C. difficile infections related to antibiotic use and infection control facilities in two university hospitals. J. Hosp. Infect. 54: 202-206.
Cohen S.H., Y.J. Tang, J. Muenzer, RH. Gumerlock and J.Jr. Silva. 1997. Isolation of various genotypes of C. difficile from patients and the environment in an oncology ward. Clin. Infect. Dis. 24: 889-893.
Kuhl S.L., Y.J. Tang, L. Nawarro, P.H. Gumerlock and J.Jr. Silva. 1993. Diagnosis and monitoring of C. difficile infections with the polymerase chain reaction. Clin. Infect. Dis. 16: 234-238.
Martirosian G., S. Kuipers, A. van Belkum, H. Verbrough and F. Meisel-Mikołajczyk. 1995. PCR ribotyping and arbitrarily primed PCR for typing of C. difficile from Polish maternity hospital. J. Clin. Microbiol. 33: 2016-2021.
Martirosian G., A. van Belkum, H. Pituch, P. Obuch-Woszczatyński and F. Meisel-Mikołajczyk. 2000. Are rapid immunoassays for in vivo detection of toxin A sufficient for diagnostic purposes of antibiotic-associated diarrhea. Anaerobe 6: 15-19.
Poxton I.R., J. Mc Coubrey and G. Blair. 2001. The pathogenicity of C. difficile. Clin. Microbiol. Infect. 7: 421-427.
Rupnik M. 2001. How to detect C. difficile variant strains in a routine laboratory. Clin. Microbiol. Infect. 7: 417-420.
Simor A.E., S.L. Yake and K. Tsimidis. 1993. Infection due to C. difficile among elderly residents of a long-term-care facility. Clin. Infect. Dis. 17: 672-678.
Szczęsny A., A. Kański, G. Martirosian. 2002. Incidence of pseumembranous colitis after vancomycin-treated MRSA infection. Clin. Microbiol. Infect. 8: 58-59.