Correlation between phenotypes or genotypes of Clostridium difficile and clinical outcome from Clostridium difficile infections at Health Sciences North

Abstract

Clostridium difficile, a Gram-positive, anaerobic, spore producing bacillus is the leading cause of nosocomial diarrhea in health-care facilities. Its effect on patients can be detrimental to their recovery, sometimes leading to death; the catalyst to Clostridium difficile infection (CDI) is treatment by antibiotics. Focusing research on some of C. difficile’s genotypes and phenotypes, we hoped to be able to predict the severity and outcome of the infections based on the strain. C. difficile strains isolated from patients were characterized for the presence of the toxin genes and classified by ribotype. They were also tested for antibiotic susceptibility (E-test), toxin production levels, and microbial spore load in stools. The patients symptoms were evaluated to determine if there were any correlations between the genotypes/phenotypes and the infection outcomes. No significant correlation was found between the severity of disease and phenotypic/genotypic attributes of the C. difficile strain involved. Thus, other defining factors appear to affect patient prognosis such as the severity of the patients’ disease and the presence of co-morbidities. A key finding however was that 30% of the population was at risk of developing CDI due to carriage of toxigenic C. difficile.