MOLECULAR ANALYSIS OF THE CLOSTRIDIUM DIFFICILE VIRULENCE GENES IN COLORECTAL CANCER PATIENTS

Abstract

Clostridium difficile (C. difficile) infections in colorectal cancer patients are a significant concern due to their potential exacerbation of existing gastrointestinal abnormalities. Excessive antibiotic use heightens the risk of C. difficile infections, particularly in cancer patients. This study aimed to assess the prevalence of C. difficile and its toxins in colorectal cancer patients undergoing antibiotic therapy and chemotherapy. A total of 50 patients with antibiotic-associated diarrhea and receiving chemotherapy were enrolled. Samples were analyzed using the immuno-chromatography test (ICT) and quantitative PCR. Additionally, the Cepheid Gene Xpert kit was employed to detect binary toxins A and B. Results revealed that 6 out of 50 patients (12%) tested positive for C. difficile and its toxins via ICT, while only 3 patients (6%) were positive through PCR. Moreover, 2 patients (4%) were found to be positive for toxin B using the Gene Xpert technique. The study's findings suggest that the prevalent C. difficile strains in this population are not highly virulent. This observation may be attributed to the early sampling strategy, conducted within the first week of initiating antibiotic therapy, possibly before the development of virulent strains. A limitation of the study was the short duration of hospital stays for most patients, necessitating early sampling. These findings underscore the need for continued monitoring and targeted interventions to mitigate C. difficile infections in colorectal cancer patients undergoing antibiotic treatment and chemotherapy.