1887

Abstract

Ninety-five isolates of from symptomatic and asymptomatic patients and 18 from their environment in the intensive-therapy units (ITUs) of four teaching hospitals in Kuwait were typed by PCR amplification of rRNA intergenic spacer regions (PCR ribotyping). A total of 32 different ribotypes was detected among the clinical isolates. The predominant ribotypes from the clinical isolates were types 097 and 078, which accounted for ∼ 40 % of all isolates in the ITUs in Kuwait. Ribotypes 097 (toxigenic), 078 (toxigenic) and 039 (non-toxigenic) were three distinct clones that were circulating in all four hospitals. Ribotypes 097, 078 and 076 (i.e. 50 % of isolates from symptomatic patients) were the predominant isolates associated with -associated disease (CDAD). The environmental isolates belonged to a diverse range of ribotypes, with no particular types common to all the hospitals. Ribotype 078 was found only in the patient environment in Mubarak hospital, while ribotype 097 was restricted to Amiri hospital. The hospital environment occupied by symptomatic as well as symptom-free patients was contaminated with . Eight new strains that did not match any in the PCR ribotype library established at the PHLS Anaerobe Reference Unit, Cardiff, UK, were assigned ribotypes 105, 125, 128, 129, 131, 134, 140 and 141. These findings show that the isolates associated with CDAD in Kuwait are different from those found in the UK and some other European countries.

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2003-08-01
2024-03-28
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References

  1. Akhter J, Markely Burdette J, Hussain Qadri S. M, Myint S. H. 1994; Aetiology of gastroenteritis at a major referral centre in Saudi Arabia. J Int Med Res 22:47–54
    [Google Scholar]
  2. Al-Barrak A, Embil J, Dyck B, Olekson K, Nicoll D, Alfa M, Kabani A. 1999; An outbreak of toxin A negative, toxin B positive Clostridium difficile -associated diarrhoea in a Canadian tertiary-care hospital. Can Commun Dis Rep 25:65–69
    [Google Scholar]
  3. Barbut F, Petit J.-C. 2001; Epidemiology of Clostridium difficile- associated infections. Clin Microbiol Infect 7:405–410 [CrossRef]
    [Google Scholar]
  4. Barbut F, Corthier G, Charpak Y. 14 other authors 1996; Prevalence and pathogenicity of Clostridium difficile in hospitalized patients.A French multicenter study. Arch Intern Med 156:1449–1454 [CrossRef]
    [Google Scholar]
  5. Bartlett J. G, Chang T. W, Gurwith M, Gorbach S. L, Onderdonk A. B. 1978; Antibiotic-associated pseudomembranous colitis due to toxin-producing clostridia. N Engl J Med 298:531–534 [CrossRef]
    [Google Scholar]
  6. Boaz A, Dan M, Charuzi I, Landau O, Aloni Y, Kyzer S. 2000; Pseudomembranous colitis: report of a severe case with unusual clinical signs in a young nurse. Dis Colon Rectum 43:264–266 [CrossRef]
    [Google Scholar]
  7. Cohen S. H, Tang Y. J, Muenzer J, Gumerlock P. H, Silva J. Jr 1997; Isolation of various genotypes of Clostridium difficile from patients and the environment in an oncology ward. Clin Infect Dis 24:889–893 [CrossRef]
    [Google Scholar]
  8. Cohen S. H, Tang Y. J, Rahmani D, Silva J. Jr 2000; Persistence of an endemic (toxigenic) isolate of Clostridium difficile in the environment of a general medicine ward. Clin Infect Dis 30:952–954 [CrossRef]
    [Google Scholar]
  9. Dallal R. M, Harbrecht B. G, Boujoukas A. J, Sirio C. A, Farkas L. M, Lee K. K, Simmons R. L. 2002; Fulminant Clostridium difficile : an underappreciated and increasing cause of death and complications. Ann Surg 235:363–372 [CrossRef]
    [Google Scholar]
  10. Djuretic T, Wall P. G, Brazier J. S. 1999; Clostridium difficile : an update on its epidemiology and role in hospital outbreaks in England and Wales. J Hosp Infect 41:213–218 [CrossRef]
    [Google Scholar]
  11. Fan K, Morris A. J, Reller L. B. 1993; Application of rejection criteria for stool cultures for bacterial enteric pathogens. J Clin Microbiol 31:2233–2235
    [Google Scholar]
  12. Johnson S, Clabots C. R, Linn F. V, Olson M. M, Peterson L. R, Gerding D. N. 1990; Nosocomial Clostridium difficile colonisation and disease. Lancet 336:97–100 [CrossRef]
    [Google Scholar]
  13. Kim K. H, Fekety R, Batts D. H, Brown D, Cudmore M, Silva J Jr, Waters D. 1981; Isolation of Clostridium difficile from the environment and contacts of patients with antibiotic-associated colitis. J Infect Dis 143:42–50 [CrossRef]
    [Google Scholar]
  14. Levett P. N. 1986; Clostridium difficile in habitats other than the human gastro-intestinal tract. J Infect 12:253–263 [CrossRef]
    [Google Scholar]
  15. Malamou-Ladas H, O'Farrell S, Nash J. Q, Tabaqchali S. 1983; Isolation of Clostridium difficile from patients and the environment of hospital wards. J Clin Pathol 36:88–92 [CrossRef]
    [Google Scholar]
  16. Martirosian G, Kuipers S, Verbrugh H, van Belkum A, Meisel-Mikolajczyk F. 1995; PCR ribotyping and arbitrarily primed PCR for typing strains of Clostridium difficile from a Polish maternity hospital. J Clin Microbiol 33:2016–2021
    [Google Scholar]
  17. McFarland L. V, Mulligan M. E, Kwok R. Y. Y, Stamm W. E. 1989; Nosocomial acquisition of Clostridium difficile infection. N Engl J Med 320:204–210 [CrossRef]
    [Google Scholar]
  18. O'Neill G. L, Ogunsola F. T, Brazier J. S, Duerden B. I. 1996; Modification of a PCR ribotyping method for application as a routine typing scheme for Clostridium difficile . Anaerobe 2:205–209 [CrossRef]
    [Google Scholar]
  19. Rivlin J, Lerner A, Augarten A, Wilschanski M, Kerem E, Ephros M. A. 1998; Severe Clostridium difficile -associated colitis in young patients with cystic fibrosis. J Pediatr 132:177–179 [CrossRef]
    [Google Scholar]
  20. Rohner P, Pittet D, Pepey B, Nije-Kinge T, Auckenthaler R. 1997; Etiological agents of infectious diarrhea: implications for requests for microbial culture. J Clin Microbiol 35:1427–1432
    [Google Scholar]
  21. Rudensky B, Rosner S, Sonnenblick M, van Dijk Y, Shapira E, Isaacsohn M. 1993; The prevalence and nosocomial acquisition of Clostridium difficile in elderly hospitalized patients. Postgrad Med J 69:45–47 [CrossRef]
    [Google Scholar]
  22. Savage A. M, Alford R. H. 1983; Nosocomial spread of Clostridium difficile . Infect Control 4:31–33
    [Google Scholar]
  23. Simor A. E, Yake S. L, Tsimidis K. 1993; Infection due to Clostridium difficile among elderly residents of a long-term-care facility. Clin Infect Dis 17:672–678 [CrossRef]
    [Google Scholar]
  24. Soyletir G, Eskiturk A, Kilic G, Korten V, Tozun N. 1996; Clostridium difficile acquisition rate and its role in nosocomial diarrhoea at a university hospital in Turkey. Eur J Epidemiol 12:391–394 [CrossRef]
    [Google Scholar]
  25. Stubbs S. L. J, Brazier J. S, O'Neill G. L, Duerden B. I. 1999; PCR targeted to the 16S-23S rRNA gene intergenic spacer region of Clostridium difficile and construction of a library consisting of 116 different PCR ribotypes. J Clin Microbiol 37:461–463
    [Google Scholar]
  26. Urban E, Brazier J. S, Soki J, Nagy E, Duerden B. I. 2001; PCR ribotyping of clinically important Clostridium difficile strains from Hungary. J Med Microbiol 50:1082–1086
    [Google Scholar]
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