The clinical and environmental spread and diversity of toxigenic Clostridium difficile diarrhea in the region of the Middle East.

Stool samples of 1822 hospitalized patients with nosocomial diarrhea and 100 environmental samples were collected at three teaching hospitals and PCR amplification of rRNA intergenic spacer regions (ISR) was conducted. Bacterial cytotoxicity was assayed by conducting three assays namely toxigeni...

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Main Authors: N., Sadeghifard, M.H., Salari, R., Ranjbar, S., Ghafouryan, M., Raftari, Abdulamir, Ahmed Sahib, Abu Bakar, Fatimah, B., Kazemi
Format: Article
Language:English
English
Published: Southern Cross Publishing 2010
Subjects:
Online Access:http://psasir.upm.edu.my/id/eprint/17035/
http://psasir.upm.edu.my/id/eprint/17035/1/The%20clinical%20and%20environmental%20spread%20and%20diversity%20of%20toxigenic%20Clostridium%20difficile%20diarrhea%20in%20the%20region%20of%20the%20Middle%20East.pdf
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author N., Sadeghifard
M.H., Salari
R., Ranjbar
S., Ghafouryan
M., Raftari
Abdulamir, Ahmed Sahib
Abu Bakar, Fatimah
B., Kazemi
author_facet N., Sadeghifard
M.H., Salari
R., Ranjbar
S., Ghafouryan
M., Raftari
Abdulamir, Ahmed Sahib
Abu Bakar, Fatimah
B., Kazemi
author_sort N., Sadeghifard
building UPM Institutional Repository
collection Online Access
description Stool samples of 1822 hospitalized patients with nosocomial diarrhea and 100 environmental samples were collected at three teaching hospitals and PCR amplification of rRNA intergenic spacer regions (ISR) was conducted. Bacterial cytotoxicity was assayed by conducting three assays namely toxigenic culture on vero cells, stool cytotoxin, and enzyme immunoassay. ISR was carried out using two universal primers complementary to conserved regions in the 16S and 23S rRNA genes. It was found that the toxigenic culture, stool cytotoxin and enzyme immunoassay showed close rates of detection of toxigenic C. difficile, 124, 121, and 122 /1822 (6.8, 6.64., and 6.7%) respectively. In addition, 32 different ribotypes for toxigenic C. difficile were detected, 28 in clinical and 6 in environmental isolates. The predominant ribotypes from the clinical isolates were 13-15, 35.6%, of isolates. Ribotypes were associated with age, location of isolation, and severity of symptoms of clostridial diarrhea (P<0.05). Ribotypes 6-9 affected children only. The most common ribotype of C. difficile , no. 13, as well as ribotypes 16, 20, and 4 covered almost the whole range of severity of symptoms. Ribotypes 21-27, 1, 3, 6, 7, 9, 11, 14, and 19 caused mild-moderate CDAD symptoms while ribotypes 5, 10 8, 12, 15, 17, and 28 were dominantly of severe symptoms (P<0.05). Environmental isolates showed 17% toxigenic strains composed of 4 different ribotypes while ribotypes 5 was shared with clinical isolates. These findings showed that C. difficile associated with diarrhea were genetically diverse and linked to environmental strains.
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spelling upm-170352015-12-18T03:05:41Z http://psasir.upm.edu.my/id/eprint/17035/ The clinical and environmental spread and diversity of toxigenic Clostridium difficile diarrhea in the region of the Middle East. N., Sadeghifard M.H., Salari R., Ranjbar S., Ghafouryan M., Raftari Abdulamir, Ahmed Sahib Abu Bakar, Fatimah B., Kazemi Stool samples of 1822 hospitalized patients with nosocomial diarrhea and 100 environmental samples were collected at three teaching hospitals and PCR amplification of rRNA intergenic spacer regions (ISR) was conducted. Bacterial cytotoxicity was assayed by conducting three assays namely toxigenic culture on vero cells, stool cytotoxin, and enzyme immunoassay. ISR was carried out using two universal primers complementary to conserved regions in the 16S and 23S rRNA genes. It was found that the toxigenic culture, stool cytotoxin and enzyme immunoassay showed close rates of detection of toxigenic C. difficile, 124, 121, and 122 /1822 (6.8, 6.64., and 6.7%) respectively. In addition, 32 different ribotypes for toxigenic C. difficile were detected, 28 in clinical and 6 in environmental isolates. The predominant ribotypes from the clinical isolates were 13-15, 35.6%, of isolates. Ribotypes were associated with age, location of isolation, and severity of symptoms of clostridial diarrhea (P<0.05). Ribotypes 6-9 affected children only. The most common ribotype of C. difficile , no. 13, as well as ribotypes 16, 20, and 4 covered almost the whole range of severity of symptoms. Ribotypes 21-27, 1, 3, 6, 7, 9, 11, 14, and 19 caused mild-moderate CDAD symptoms while ribotypes 5, 10 8, 12, 15, 17, and 28 were dominantly of severe symptoms (P<0.05). Environmental isolates showed 17% toxigenic strains composed of 4 different ribotypes while ribotypes 5 was shared with clinical isolates. These findings showed that C. difficile associated with diarrhea were genetically diverse and linked to environmental strains. Southern Cross Publishing 2010 Article PeerReviewed application/pdf en http://psasir.upm.edu.my/id/eprint/17035/1/The%20clinical%20and%20environmental%20spread%20and%20diversity%20of%20toxigenic%20Clostridium%20difficile%20diarrhea%20in%20the%20region%20of%20the%20Middle%20East.pdf N., Sadeghifard and M.H., Salari and R., Ranjbar and S., Ghafouryan and M., Raftari and Abdulamir, Ahmed Sahib and Abu Bakar, Fatimah and B., Kazemi (2010) The clinical and environmental spread and diversity of toxigenic Clostridium difficile diarrhea in the region of the Middle East. Reviews in Infection, 1 (4). pp. 180-187. ISSN 1837-6746 Diarrhea. Disease management. Environmental responsibility. English
spellingShingle Diarrhea.
Disease management.
Environmental responsibility.
N., Sadeghifard
M.H., Salari
R., Ranjbar
S., Ghafouryan
M., Raftari
Abdulamir, Ahmed Sahib
Abu Bakar, Fatimah
B., Kazemi
The clinical and environmental spread and diversity of toxigenic Clostridium difficile diarrhea in the region of the Middle East.
title The clinical and environmental spread and diversity of toxigenic Clostridium difficile diarrhea in the region of the Middle East.
title_full The clinical and environmental spread and diversity of toxigenic Clostridium difficile diarrhea in the region of the Middle East.
title_fullStr The clinical and environmental spread and diversity of toxigenic Clostridium difficile diarrhea in the region of the Middle East.
title_full_unstemmed The clinical and environmental spread and diversity of toxigenic Clostridium difficile diarrhea in the region of the Middle East.
title_short The clinical and environmental spread and diversity of toxigenic Clostridium difficile diarrhea in the region of the Middle East.
title_sort clinical and environmental spread and diversity of toxigenic clostridium difficile diarrhea in the region of the middle east.
topic Diarrhea.
Disease management.
Environmental responsibility.
url http://psasir.upm.edu.my/id/eprint/17035/
http://psasir.upm.edu.my/id/eprint/17035/1/The%20clinical%20and%20environmental%20spread%20and%20diversity%20of%20toxigenic%20Clostridium%20difficile%20diarrhea%20in%20the%20region%20of%20the%20Middle%20East.pdf