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Table 2 Clostridium difficile studies from the Greater Mekong Subregion

From: Clostridium difficile infection in the Lao People’s Democratic Republic: first isolation and review of the literature

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]