Molecular and culture-based diagnosis of Clostridium difficile isolates from Côte d'Ivoire after prolonged storage at disrupted cold chain conditions.

Abstract

BACKGROUND Although Clostridium difficile is a major cause of diarrhoea, its epidemiology in tropical settings is poorly understood. Strain characterisation requires work-up in specialised laboratories, often after prolonged storage without properly maintained cold chain. METHODS We screened 298 human faecal samples from Côte d'Ivoire using a rapid test for C. difficile glutamate dehydrogenase (GDH). GDH-positive samples were aerobically stored at disrupted cold chain conditions (mean duration: 11 days) before transfer to a reference laboratory for anaerobic culture, susceptibility testing, PCR assays and ribotyping. RESULTS Sixteen samples (5.4%) had a positive GDH screening test. C. difficile infection was confirmed in six specimens by culture and PCR, while no nucleic acids of C. difficile were detected in the culture-negative samples. Further analysis of stool samples harbouring toxigenic C. difficile strains confirmed that both GDH and toxins remained detectable for at least 28 days, regardless of storage conditions (aerobic storage at 4°C or 20°C). CONCLUSIONS Storage conditions only minimally affect recovery of C. difficile and its toxins in stool culture. A rapid GDH screening test and subsequent transfer of GDH-positive stool samples to reference laboratories for in-depth characterisation may improve our understanding of the epidemiology of C. difficile in the tropics.

DOI: 10.1093/trstmh/trv071

Cite this paper

@article{Becker2015MolecularAC, title={Molecular and culture-based diagnosis of Clostridium difficile isolates from C{\^o}te d'Ivoire after prolonged storage at disrupted cold chain conditions.}, author={S{\"{o}ren L. Becker and Justin K. Chatigre and Jean T. Coulibaly and P. B. A. Mertens and Bassirou Bonfoh and Mathias Herrmann and Ed J. Kuijper and Eli{\'e}zer K N'Goran and J{\"{u}rg Utzinger and Lutz von Mueller}, journal={Transactions of the Royal Society of Tropical Medicine and Hygiene}, year={2015}, volume={109 10}, pages={660-8} }