id	author	title	date	pages	extension	mime	words	sentence	flesch	summary	cache	txt
ajlm-1809	Singh, Sarishna; Newton-Foot, Mae; Nel, Pieter; Pienaar, Colette	Comparison of commercial assays and two-step approach to detect Clostridioides difficile in South Africa	2022		.htm	text/html	4544	201	47	C. difficile infection is associated with an asymptomatic carrier state, self-limiting diarrhoea, pseudomembranous colitis, and toxic megacolon which can be fatal.1 C. difficile infection accounts for up to 20% of nosocomial diarrhoea cases worldwide.2 In South Africa, there is very little published data regarding the incidence and prevalence of C. difficile; a previous study in patients with diarrhoea reported the prevalence to be 16%.3 C. difficile infection associated with increased severity and mortality has been reported in North America and Europe.5 The C. difficile strain responsible for these outbreaks, the hypervirulent 027/NAP1/BI, is characterised by a deletion in the tcdC gene (a negative regulator of tcdA and tcdB expression), resulting in increased production of Toxin A and Toxin B.6 Certain strains of C. difficile may produce a binary toxin, C. difficile transferase, encoded by cdtA and cdtB. Data regarding binary toxin conflict, with some studies suggesting its significance is unclear whereas others have shown that it may be associated with a higher mortality rate.7,8,9 Accurate diagnosis of C. difficile infection is essential as it guides patient management and infection control practices.	cache/ajlm-1809.htm	txt/ajlm-1809.txt