Table 2.
Clostridium difficile studies from the Greater Mekong Subregion
| Location, Country | Number positive/number tested | Clinical presentation | Test method | Gene | Ribotypes (number positive) | Year of study | Reference |
|---|---|---|---|---|---|---|---|
| Bangkok, Thailand | 123/279 (44%) (106/203 patients with diarrhoea 17/76 healthy controls) |
Patients with diarrhoea and healthy controls. 84% of patients infants aged 0–3 years | Tissue culture cytotoxin assay | 1990 | [32] | ||
| Bangkok, Thailand | 21/320 (6.5%) (15/140 clindamycin treated patients, 14/140 β-lactam-treated patients, 2/140 controls) |
Antibiotic treated patients and healthy controls. All >15 years | Toxin A EIA (TechLab, BioWhittaker) | 1991–1994 | [12] | ||
| Bangkok, Thailand | 77/443 (17.4%) (28/235 asymptomatic infants 16/76, asymptomatic children, 20/48 antimicrobial treated adults, 13/84 non-antimicrobial-treated adults) |
Asymptomatic infants <12 months old, asymptomatic children 1–11 years old, antimicrobial treated diarrheal adults, non-antimicrobial treated diarrheal positive adults | Culture on cycloserine-cefoxitin-fructose agar, tcdA gene confirmed by in- house PCR | 20 tcdA positive (2 from the infants and children group, 10 from antimicrobial treated adults and 8 from non-antimicrobial treated adults) | 1998–1999 | [16] | |
| Bangkok, Thailand | 140/472 (29.6%) (20/34 HIV-positive diarrheal patients, 21/167 HIV-positive non-diarrheal patients, 99/271 HIV-negative diarrhoeal patients) |
HIV-positive diarrheal patients, HIV-positive non diarrheal patients and HIV-negative diarrheal patients | Cultured on cycloserine-cefoxitin-fructose agar (CCFA, Oxoid) CD-D1 latex kit (Mitsubishi Chemical Industries, Tokyo) | Unknown (published 2000) | [33] | ||
| Bangkok, Thailand | 16/102 (15.6%) | HIV patients with diarrhoea | Toxin A EIA (Oxoid) | 1999–2000 | [13] | ||
| Bangkok, Thailand | 53 | Patients with suspected C. difficile infection | Qualitative immunochromatographic assay (Xpect C. difficile toxin A/B test; Thermo scientific, Lenexa, KS, USA), 5-plex PCR and an in-house PCR for the presence of tcdA |
tcdA, tcdB | UK 017 (23), UK 014/020 (13), QX370 (1) | 2006–2008 | [17] |
| Bangkok, Thailand | 25/203 (12.3%) | Diarrheal inpatients (>14 years old) | Immunochromatography (Remel Xpect) | tcdA, tcdB | 2008 | [34] | |
| Bangkok, Thailand | 47/175 (26.8%) | Hospital patients (≥15 years) | Toxin A/B by EIA (VIDAS; bioMerieux), tcdB by PCR | tcdB | 2010–2011 | [14] | |
| Bangkok, Thailand | 105/422 (24.9%) | Hospital patients with diarrhoea >18 years | Cultured on C. difficile ChromID agar (bioMérieux, Marcy l’Etoile, France), in-house PCRs for the presence of tcdA and tcdB, and binary toxin genes (cdtA and cdtB) |
39 toxigenic- 27 tcdA, 12 tcdB | 014/020 (17), 010 (12), 017 (12), 039 (9), 009 (6) | 2015 | [19] |
| Thailand | 107/574 (18.6%) | Hospital patients with diarrhoea | EIA (Meridian Premier Cytoclone), PCR | 48 tcdA and tcdB positive by PCR | Unknown (published 2003) | [35] | |
| Vietnam | 45/479 (9.4%) | Hospital patients with diarrhoea | Luminex xTAG gastrointestinal pathogen panel assay (Luminex Molecular Diagnostics, Austin, TX, USA) | 30 tcdA and 15 tcdB | 2009–2014 | [36] |