Clostridium difficile infections (CDIs) is considered healthcare-associated infections which cause
watery diarrhea to long stayed hospitalized patients and cause increased mortality rate.
Aim: Detection of the prevalence and risk factors of C. difficile in Al Quwayiyah General hospital,
Riyadh, Kingdom of Saudi Arabia and compairing between GeneXpert® PCR assay and Quikchek
complete-enzyme imunoassay QCC, (QCC-EIA) in detection of C. difficile infection and toxicity
Materials and Methods: A cross sectional and prospective study was performed for one year
started from June 2019 to June 2020. The data collected include demographic, laboratory and
clinical data. A total of 104 stool samples were collected from patients presented with diarrhea.
GeneXpert® PCR assay and Quikchek complete-enzyme imunoassay QCC (QCC-EIA) were
conducted to each stool sample.
Results: Only 15(14.4%) of the 104 studied patients had CDI while 89 (85.6%) were non CDI
Original Research Article
Khater and Al-Faki; MRJI, 30(9): 94-102, 2020; Article no.MRJI.63799
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patients, 13 (86.7%) of the CDI patients were males and 2 (13.3%) were females with mean age for
CDI cases 61 (±19.9), while non CDI cases involved 55(61.8%) were males and 34 (38.2%) were
females with mean age for cases of non CDI, 60 (±18.7) years. Of the CDI and non CDI cases
respectively 12 (80%) and 14(15.7%) had fever, 5 (27%) and 6 (6.7%) had vomitting and 7 (46.7%)
and 12 (13.5%) of cases had abdominal pain. There was statistical significant difference between
patients with fever while no statistical significant difference regarding vomitting and abdominal pain.
There was statistical significant difference between patients with peptic ulcers, patients received
proton pump inhibitors and patients received broad-spectrum antibiotics, while There was no
statistical significant difference between cardiac disease, cerebrovascular disease, diabetes,
pulmonary disease, hepatic disease and Renal disease. Gene expert PCR detected 15/104(14.4%)
as positive CDI while QCC-EIA detected 21/104 (20.5%) as positive CDI. On comparison between
gene expert PCR technique and QCC-EIA the sensitivity of QCC-EIA was 100%, while the
specificity was 91%. The Positive Predictive Value was 74%, while the Negative Predictive Value
was 100%.
Conclusion: The C. difficile infection prevalence rate in the hospital was 14.4%. There was
statistical significant difference between patients with peptic ulcers, patients received proton pump
inhibitors and patients received broad-spectrum antibiotics. The QCC-EIA can be used as a
screening test for the detection of C. difficile toxin in stool samples but should be confirmed with a
PCR assay or another confirmatory test Due to its decreased specificity. |
