Clostridium difficile in patients with nosocomial diarrhea, Northwest of Iran

Clostridium difficile is known as a prevalent pathogen leading to infections ranging from mild diarrhea to severe disease and death. The aim of the present study was to evaluate the incidence of C. difficile from inpatients with nosocomial diarrhea hospitalized in different wards in the northwest region of Iran.

In this cross-sectional study, 485 diarrheal stool samples were collected from 384 patients referred from different wards of Imam Reza, Sina and Pediatric hospitals, Tabriz and transferred to the laboratory from 25 March 2015 till 1 March 2018. Immuno-chromatographic assay for detection of toxins A and B of C. difficile was used for identification.

Clostridium difficile was isolated from 24 (4.7%) out of 485 samples. Fifteen patients (62.5%) were males and 9 were females (37.5%). Twelve positive patients were from the gastrointestinal ward (50%), 5 patients (20.8%) from surgery ward, 3 patients from infectious disease ward (12.5%), 3 patients from rheumatology ward (12.5%) and 1 patient (4.1%) were collected from neurology ward. 95.3% of diarrhea samples had no signs from toxin A and B.

These results indicate most of infected patients were from the gastrointestinal and surgery wards which show a different pattern of infection compared to previous studies. The neurology department had the lowest rate of infection. C. difficile is a health threat after antibiotic consumption and for health promotion, developing strategies for less antibiotic consumption and preventing these emerging infections is critical. The low rate of this infection shows improvement in knowledge and effect of stewardships in physicians.