Clostridioides difficile infections in Saudi Arabia: Where are we standing?

Obaid, Najla A.; Alhifany, Abdullah A.

doi:10.1016/j.jsps.2020.07.013

Cited by 7 publications

(7 citation statements)

References 25 publications

(52 reference statements)

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“…A study by Al-Eidan et al [27] also showed that the clinical manifestations of C. difficile infection in most of hospitalized patients included diarrhoea, fever, abdominal pain, and leucocytosis. Basically, CDI diagnosis should depends on stool positive reports as well as clinical symptoms; however, all of the previous studies in Saudi Arabia defined their positive results only upon laboratory investigations of loose stools, without interpreting their findings with patients' clinical symptoms [11].…”

Section: Discussionmentioning

confidence: 99%

“…In brief, 25 ml stool sample was added to a tube containing the diluent and conjugate, then transferred to the well of device sample. After 15 min incubation at room temperature, the wash buffer and then the substrate were added to the reaction window [11]. The results interpretation as per manufacturer guidelines.…”

Section: Gdh Antigen And/or Toxins Were Detected Bymentioning

confidence: 99%

“…The main drawback of this technique is that it sometimes detects C difficile bacteria regardless of toxin production that lead to over-diagnosis of CDIs, knowing that about 21% of hospitalized patients are colonized with C. difficile without any symptoms [4,10]. The detection of CDIs using EIAs needs confirming the positive cases with the NAAT in the two step protocol recommended by Infectious Diseases Society of America (IDSA) for CDIs diagnosis [11].…”

Section: Introductionmentioning

confidence: 99%

“…One of the GeneXpert® PCR assay advantage is that it is multiplex system which uses closed cartridge-based system to extract, amplify and detect nucleic acid, reducing the chance for contamination and false-positive results. Moreover GeneXpert® PCR assay detects the presence of toxin-producing C. difficile in short time about 47 minutes so it has advantage of both speed and accuracyintesting [11].…”

Section: Introductionmentioning

confidence: 99%

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Detection of Clostridium difficile Infection in Al-Quwayiyah General Hospital, Riyadh, Kingdom of Saudi Arabia

Khater

Faki²

2020

MRJI

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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 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.

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Section: Discussionmentioning

confidence: 99%

Section: Gdh Antigen And/or Toxins Were Detected Bymentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Detection of Clostridium difficile Infection in Al-Quwayiyah General Hospital, Riyadh, Kingdom of Saudi Arabia

Khater

Faki²

2020

MRJI

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“…The prevalence rate of CDI among patients with diarrhea in Egypt is 23.6% ( Abu Faddan et al, 2016 ), in Lebanon is 65.2% ( Moukhaiber et al, 2015 ) and in Jordan is 92.4% ( Wadi et al, 2015 ). In Saudi Arabia, there is no published study about prevalence of CDI on a national level, yet, few reports of single-center studies detected low rate of CDIs ( Obaid and Alhifany, 2020 ). One of these studies reported 4.6% prevalence rate of CDI among patients with diarrhea ( Shehabi et al, 2015 ).…”

Section: Introductionmentioning

confidence: 99%

Raw Animal Meats as Potential Sources of Clostridium difficile in Al-Jouf, Saudi Arabia

Taha¹

2021

Food Sci Anim Resour

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Clostridium difficile present in feces of food animals may contaminate their meats and act as a potential source of C. difficile infection (CDI) to humans. C. difficile resistance to antibiotics, its production of toxins and spores play major roles in the pathogenesis of CDI. This is the first study to evaluate C. difficile prevalence in retail raw animal meats, its antibiotics susceptibilities and toxigenic activities in Al-Jouf, Saudi Arabia. Totally, 240 meat samples were tested. C. difficile was identified by standard microbiological and biochemical methods. Vitek-2 compact system confirmed C. difficile isolates were 15/240 (6.3%). Toxins A/B were not detected by Xpect C. difficile toxin A/B tests. Although all isolates were susceptible to vancomycin and metronidazole, variable degrees of reduced susceptibilities to moxifloxacin, clindamycin or tetracycline antibiotics were detected by Epsilon tests. C. difficile strains with reduced susceptibility to antibiotics should be investigated. Variability between the worldwide reported C. difficile contamination levels could be due to absence of a gold standard procedure for its isolation. Establishment of a unified testing algorithm for C. difficile detection in food products is definitely essential to evaluate the inter-regional variation in its prevalence on national and international levels. Proper use of antimicrobials during animal husbandry is crucial to control the selective drug pressure on C. difficile strains associated with food animals. Investigating the protective or pathogenic potential of non-toxigenic C. difficile strains and the possibility of gene transfer from certain toxigenic/ antibiotics-resistant to non-toxigenic/antibiotics-sensitive strains, respectively, should be worthy of attention.

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Vancomycin vs metronidazole use for the treatment of Clostridioides difficile infection in a tertiary care hospital in Saudi Arabia

Alhameed,

Saferuddin,

Alturkistani

et al. 2023

Heliyon

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Clostridioides difficile infections in Saudi Arabia: Where are we standing?

Cited by 7 publications

References 25 publications

Detection of Clostridium difficile Infection in Al-Quwayiyah General Hospital, Riyadh, Kingdom of Saudi Arabia

Detection of Clostridium difficile Infection in Al-Quwayiyah General Hospital, Riyadh, Kingdom of Saudi Arabia

Raw Animal Meats as Potential Sources of Clostridium difficile in Al-Jouf, Saudi Arabia

Vancomycin vs metronidazole use for the treatment of Clostridioides difficile infection in a tertiary care hospital in Saudi Arabia

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