Abstract:

Objective To analyze the toxicity characteristics of Clostridium difficile in different intestine states of inpatients，and to provide a reference for the prevention and treatment of Clostridium difficile infection （CDI）. Methods The 432 fecal samples of inpatients were collected from Beijing Friend Hospital of Capital Medical University from February to June 2019. All the patients were classified into diarrhea group （198 cases） and diarrhea-free group （234 cases） based on whether they had diarrhea symptoms. The isolates of Clostridium difficile were isolated from the fecal samples. The isolates were determined for toxin gene，toxin protein expression and cytotoxicity test. The results of 2 groups were analyzed statistically. Results There was no statistical significance in the positive rate of toxin gene between the 2 groups（P>0.05）. The toxin protein expression of diarrhea group was higher than that of diarrhea-free group（P<0.05）. The results of cytotoxicity test showed that the 2 groups had lesions，but the number of cell death in diarrhea group was higher than that in diarrhea-free group （P<0.05）. Conclusions Both toxic and non-toxic Clostridium difficile can colonize without diarrhea in inpatients. The increase in toxin production and toxicity of Clostridium difficile are factors in the clinical presence of diarrhea symptoms.

Key words: Clostridium difficile, Asymptomatic colonization, Pathogenicity, Inpatient, Diarrhea