C. Difficile in Hiv Infection

The prevalence of Clostridium difficile infections in HIV-positive patients with regard to the presence of its enterotoxin was investigated. Enzyme immunoassay (EIA, Meridian Diagnostic Inc) was used for the detection of C. difficile enterotoxin in stool specimens collected from 201 HIV-positive and 271 HIV-negative diarrheal patients. Culture was performed on cycloserine cefoxitin fructose agar. Chromosomal DNA types of C. difficile isolates were determined by pulsed-field gel electrophoresis (PFGE). In the HIV-positive group, C. difficile enterotoxin was found in 58.8% and 12.6% of diarrheal and non-diarrheal patients, repectively, whereas this toxin was found in 36.5 % of HIV-negative-diarrheal patients. However, 13.6% of stool samples were negative by toxin assay, but were positive for C. difficile by culture and latex agglutination test. Among 11 isolates from both HIV-positive and HIV-negative patients, 6 patterns of PFGE type were observed: A, B, C, D, E and F. This work was presented in part at the 9 European Congress of Clinical Microbiology and Infectious Diseases, Berlin, March 1999. SOUTHEAST ASIAN J TROP MED PUBLIC HEALTH Vol 31 No. 3 September 2000 538 photographed under UV light. Chromosomal DNA of Saccharomyces cerevisiae (Bio-Rad Laboratories) was used for molecular standard markers. Statistical analysis Data were analysed using Epi Info Software version 6. Categorical variables were compared using chi-square test. A p-value of < 0.05 was considered significant, and all tests were two-tailed.