Prevalence of gastrointestinal pathogenic bacteria in patients with diarrhoea attending Groote Schuur Hospital, Cape Town, South Africa

Abstract

Background. Diarrhoea due to gastrointestinal infections is a significant problem facing the South African (SA) healthcare system. Infections can be acquired both from the community and from the hospital environment itself, the latter acting as a reservoir for potential pathogenic bacteria. Objectives. To examine the prevalence of a panel of potential diarrhoeacausing bacteria in patients attending a tertiary healthcare facility in Cape Town, SA. Methods. Polymerase chain reaction (PCR) primers specific for Clostridium difficile, Shigella spp., Salmonella spp., Klebsiella oxytoca, enteropathogenic and enterohaemorrhagic Escherichia coli (EPEC/EHEC), Staphylococcus aureus, enterotoxigenic Bacteroides fragilis and Campylobacter spp. were used to screen total bacterial genomic DNA extracted from stool samples provided by 156 patients with diarrhoea attending Groote Schuur Hospital, Cape Town, SA. Results. C. difficile was the most frequently detected pathogen (16% of cases) in the 21 87yearold patient range, but was not present in samples from the 16 20yearold range. K. oxytoca (6%), EPEC/EHEC strains (9%) and S. aureus (6%) were also detected. The remaining pathogens were present at low frequencies (0 2.9%), and the occurrence of mixed infections was 5%. The majority of nonC. difficilerelated diarrhoeas were community acquired. Conclusion. C. difficile was the main cause of infectious diarrhoea in the sampled patients, while K. oxytoca and EPEC/EHEC strains were present as relatively minor but potentially significant pathogens.

Clostridium difficile infection in low‐ and middle‐human development index countries: a systematic review

“…Twenty‐five studies met criteria for qualitative synthesis (Table ) . Twenty (80%) were observational studies, three (12%) studies were case–control and two (8%) were cohort studies.…”

Clostridium difficile in patients attending tuberculosis hospitals in Cape Town, South Africa, 2014–2015

“…24,25 In South Africa, studies carried out in the Vhembe district of Limpopo province and Cape Town in the Western Cape report a prevalence of toxigenic C. difficile of between 10% and 20% in patients with diarrhoea. 26,27,28 However, at least two of the previous studies undertaken in the country relied on diagnostic testing that detected toxin A alone, meaning that the rate of CDI in the country may be underestimated. 27,29 Additionally, epidemiological information regarding CDI and the strains responsible for disease is currently lacking, particularly for HIV-positive/tuberculosis-positive patients, who may be at an increased risk of developing CDI.…”

Development of a real-time PCR assay and comparison to CHROMagarTM STEC to screen for Shiga toxin-producing Escherichia coli in stool, Cape Town, South Africa

“…The prevalence of stx genes in stool samples (6.2%) was lower than the 9% previously reported by Kullin et al, 2015. 24 Among the 53 isolates that formed mauve colonies on CHROMagar TM STEC, five were STEC (two serotype O26 and others non-typeable), four were enteroaggregative E. coli (serotype O104), two were atypical EPEC (serotype O101 and non-typeable) and two were typical EPEC (serotype O55). Serotypes O26 and O104 are among the top six STEC serotypes globally.…”