Objective: Clostridium difficile is the most frequently associated agent in infectious nosocomial diarrhea and antibiotics are believed to be the most important risk factors. In this study, it was aimed to investigate the presence of toxigenic C. difficile in patients with antibiotic associated diarrhea and to determine the related risk factors.

Materials and Methods: C. difficile and its toxins were investigated by a commercial enzyme immunoassay kit (ImmunoCard Toxins A&B, Meridian Diagnostics, Belgium) and anaerobe culture method in a total of 250 stool samples collected from hospitalized patients who had used antibiotics within the last three weeks and developed antibiotic- associated diarrhea between March 2009-May 2010. C. difficile strains were identified by conventional methods and distinct biochemical characteristics using API 20A panel.

Results: Enzyme immunoassay revealed positive results for toxin A-B in 10 (4%) of 250 stool samples and these samples also yielded the bacteria in anaerobe culture. Toxin A-B positivity was more common in 2-4 year- age group and in patients over 65 years old. C. difficile positive patients had underlying diseases such as malignancies and immune deficiency. The most frequently used antibiotics among these patients were third generation cephalosporins, followed by meropenem, amikacin, netilmicin and tigecycline.

Conclusion: Investigation of C. difficile and its toxins in hospitalized patients with antibiotic associated diarrhea is important in order to ensure early diagnosis and treatment. Our study is the first study performed about this topic in our region and we think that our data will contribute to clinicians' approach to C. difficile infections.