[The use of molecular methods in the diagnosis of Clostridium difficile infections].

Grazyna Dulny, Grazyna Nurzyńska, Szymon Walter de Walthoffen, Agnieszka Kraśnicka, Grazyna Młynarczyk
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Abstract

Introduction: The aim of this study was to use molecular methods to identify selected strains of C. difficile isolated from patients hospitalized at Independent Public Central Teaching Hospital [SP CSK] between 2008 and 2011 in order to demonstrate their toxicgenic character and to determine their epidemic potential, including the incidence of a suspected C. difficile strain 027/NAP1/B1.

Material and methods: Originally evaluated material consisted of freshly collected stool samples from patients who had developed diarrhea. Stool samples were assessed for toxins A and B via an immunoenzymatic method and for the presence of C. difficile via the first culture method. The isolated strains were stored on MICROBANK mediums, at -70 degrees C. From this sample collection, 48 strains isolated in 2008 and 28 strains isolated in 2011 were selected for molecular analysis.

Results: Among the C. difficile isolates that underwent molecular analysis there were 6 strains 027/NAP1/BI out of the 48 evaluated strains isolated in 2008, which constituted 12.5% and 24 strains 027/NAP1/BI out of the 28 strains isolated in 2011, which constituted 85.7%.

Conclusions: Identification of a possible hyperepidemic strain of C. difficile is crucial for undertaking any anti-epidemic activities in health care facilities, where such activities are more and more common and are responsible for nosocomial foci of infection.

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分子方法在艰难梭菌感染诊断中的应用
本研究的目的是利用分子方法鉴定2008年至2011年在独立公立中央教学医院[SP CSK]住院的患者分离的艰难梭菌菌株,以证明其毒性特征并确定其流行潜力,包括可疑艰难梭菌027/NAP1/B1的发病率。材料和方法:最初评估的材料包括从患有腹泻的患者新鲜收集的粪便样本。通过免疫酶法评估粪便样本中的毒素A和B,并通过第一种培养法评估艰难梭菌的存在。分离菌株保存在-70℃的MICROBANK培养基中,从该样本中选择2008年分离的48株和2011年分离的28株进行分子分析。结果:在进行分子分析的艰难梭菌分离株中,2008年分离的48株评估菌株中有6株为027/NAP1/BI,占12.5%;2011年分离的28株菌株中有24株为027/NAP1/BI,占85.7%。结论:鉴定一种可能的难辨梭菌高流行菌株对于在卫生保健机构开展任何抗流行病活动至关重要,在卫生保健机构中,此类活动越来越普遍,并且是医院感染焦点的原因。
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