The impact of the molecular diagnosis in the surveillance of the Clostridium difficile infection.

Clostridium difficile is the agent of many cases of antibiotic associated diarrhea. The prevalence of the toxigenic Clostridium difficile strains was assessed by real-time PCR between May 2014- January 2015, at the Emergency University Hospital, Bucharest, Romania. The incidence of the Clostridium difficile infection was 0.47%. Among the 1119 stool specimens tested, 165 (13.8%) were positive for C. difficile toxins A and B by immunochromatography test. All 165 positive samples were investigated by real time PCR and 134 (81%) samples were positive for toxin B and for the binary toxin, while the rest were positive for toxin B. A high number of samples positive for binary toxin was recorded in the General surgery department (29.85%), Neurology (13.43%), and Internal medicine (12.68%). Many of the infected patients presented as underlying pathology, cancer, diabetes mellitus and stroke. A rapid decision concerning the antibiotic therapy was made, to decrease the risk of nosocomial spread.