Investigation of toxigenic clostridium difficile-associated diarrhea by culture, GHL enzyme, toxin A/B elisa and pcr at hospitalized patients with two years and older in Akdeniz University Medical School Hospital

In this study we aim to explore the existance of toxin by EIA method in patient's stool sample with diarrhea thought to be due to C. difficile. In addition isolation of C. difficile origins from culture of same samples and toxin exploration performed by PCR to investigate the frequency of C. difficile induced diarrhea in our hospital. Thıs study consist of 200 patients above 2 years old in Akdenız University hospital Central Laboratory ELISA Unit for exploration of C. difficile toxin A/B in stool samples between July 2013-November 2013. Stool samples are planted in CDSA selective medium and anaerobic culture performed. Isolated microorganisms are defined by MALDI-TOF-MS (Bruker Daltonıcs Mıcroflex LT System, Becton Dıckınson, Italy s.p.a) Toxigenic culture performed by PCR or ELISA method in C.difficile positive samples with existance of toxin. At the same time GDH and Toxin B studied by EIA (C. diff Quik Check Complete (CDQCC), Techlab, Blacksburg, va, USA) whereas toxin B gene by PCR (BD max Cdiff, BD Diagnostics) Toxigenic culture is considered as referance test. CDE frequency is found as 6.5 % in our patient populatıon. All of 13 samples which are positive for toxigenic culture, are positive for EIA GDH test. Poiİtivity is detected in 11 of 13 samples byEIA toxin test and 12 of 13 samples by PCR test. Accordin to our results GDH EIA test can be used as screening test in risky patient population. Positive results must be verified by EIA test which detect toxin A+B and molecular test which detect toxin B gene. Toxigenic culture must be performed when incompetible situations occured between the test result and patient's clinic.