Prevalence of Clostridium difficile toxin genes in Pretoria

Abstract

The hypervirulent polymerase chain reaction (PCR) ribotype 027 strain of Clostridium difficile produces toxins A, B and a binary toxin. Toxin detection kits are commonly used in diagnostic laboratories, but have been unsuccessful in detecting all of the relevant C. difficile strains, and the toxins produced. In this study, conventional PCR was used to detect the presence of the genes of toxin A, toxin B and the binary toxin of C. difficile. Eighty-four frozen (collected between 2006-2007) and 13 fresh (collected in 2010) stool specimens, obtained in Pretoria, were analysed. The genes for toxin A, toxin B and the binary toxin were detected in one of the fresh stool specimens. This may have implications for healthcare facilities, and suggests the possible emergence of the highly virulent PCR ribotype 027 strain of C. difficile in Pretoria. This emphasises the importance of continuous surveillance and monitoring of C. difficile outbreaks.