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<p class=\"MsoNormal\" style=\"margin-bottom: .0001pt; text-align: justify; text-justify: inter-ideograph; line-height: normal; tab-stops: right 6.0in; mso-layout-grid-align: none; text-autospace: none;\"><strong><span style=\"font-size: 10.0pt; font-family: \'Times New Roman\',\'serif\'; color: #131313;\" lang=\"EN-IN\">Abstract</span></strong><span style=\"font-size: 10.0pt; font-family: \'Times New Roman\',\'serif\'; color: #131313;\" lang=\"EN-IN\">: </span></p>
<p class=\"MsoNormal\" style=\"margin-bottom: .0001pt; text-align: justify; text-justify: inter-ideograph; line-height: normal; tab-stops: right 6.0in; mso-layout-grid-align: none; text-autospace: none;\"><span style=\"font-size: 10.0pt; font-family: \'Times New Roman\',\'serif\'; color: #131313;\" lang=\"EN-IN\">&nbsp;</span></p>
<p class=\"MsoNormal\" style=\"margin-bottom: .0001pt; text-align: justify; text-justify: inter-ideograph; line-height: normal; mso-layout-grid-align: none; text-autospace: none;\"><em style=\"mso-bidi-font-style: normal;\"><span style=\"font-size: 10.0pt; font-family: \'Times New Roman\',\'serif\';\" lang=\"EN-IN\">Infection with toxin-producing <span style=\"mso-bidi-font-style: italic;\">Clostridium difficile </span>strains is a common cause of diarrhoea. <span style=\"mso-bidi-font-weight: bold; mso-bidi-font-style: italic;\">Clostridium difficile presently has been identified as a causative agent of </span><span style=\"color: #292526;\">a spectrum of diseases referred to as </span><span style=\"mso-bidi-font-weight: bold; mso-bidi-font-style: italic;\">Clostridium difficile Infections</span><span style=\"color: #292526;\"> (CDI). CDI can manifest as self-limiting antibiotic-associated diarrhoea (AAD) and antibiotic-associated colitis (AAC) to severe and life threatening forms like; pseudomembranous colitis (PMC) and toxic megacolon. </span><span style=\"color: #131313;\">Indian studies have reported </span><span style=\"mso-bidi-font-weight: bold; mso-bidi-font-style: italic;\">Clostridium difficile</span><span style=\"color: #292526;\">-associated Diarrhoea</span><span style=\"color: #131313;\">(CDAD) prevalence rates ranging from 7.1% to 26.6% and its </span></span></em><em style=\"mso-bidi-font-style: normal;\"><span style=\"font-size: 10.0pt; font-family: \'Times New Roman\',\'serif\'; mso-fareast-font-family: \'Times New Roman\'; color: black; mso-bidi-font-weight: bold;\" lang=\"EN-IN\">incidence varies considerably from place to place. </span></em></p>
<p class=\"MsoNormal\" style=\"margin-bottom: .0001pt; text-align: justify; text-justify: inter-ideograph; line-height: normal; mso-layout-grid-align: none; text-autospace: none;\"><strong><em style=\"mso-bidi-font-style: normal;\"><span style=\"font-size: 10.0pt; font-family: \'Times New Roman\',\'serif\'; mso-fareast-font-family: \'Times New Roman\'; color: black;\" lang=\"EN-IN\">Objective: </span></em></strong><em style=\"mso-bidi-font-style: normal;\"><span style=\"font-size: 10.0pt; font-family: \'Times New Roman\',\'serif\'; color: #131313;\" lang=\"EN-IN\">The present work was conducted to study </span></em><em><span style=\"font-size: 10.0pt; font-family: \'Times New Roman\',\'serif\'; mso-bidi-font-weight: bold;\" lang=\"EN-IN\">Clostridium difficile</span></em><em style=\"mso-bidi-font-style: normal;\"><span style=\"font-size: 10.0pt; font-family: \'Times New Roman\',\'serif\'; color: #131313;\" lang=\"EN-IN\"> and its prevalence in the South Gujarat Region of the Gujarat state of India. </span></em></p>
<p class=\"MsoNormal\" style=\"margin-bottom: .0001pt; text-align: justify; text-justify: inter-ideograph; line-height: normal; tab-stops: right 6.0in; mso-layout-grid-align: none; text-autospace: none;\"><strong><em style=\"mso-bidi-font-style: normal;\"><span style=\"font-size: 10.0pt; font-family: \'Times New Roman\',\'serif\'; color: #131313;\" lang=\"EN-IN\">Method: </span></em></strong><em style=\"mso-bidi-font-style: normal;\"><span style=\"font-size: 10.0pt; font-family: \'Times New Roman\',\'serif\'; color: #131313;\" lang=\"EN-IN\">Alcohol Shock treatment was given to the diarrhoeal stool sample, followed by enrichment of spores by inoculating an RCM broth (added with 0.1% sodium taurocholate). After 48 hr., subculture was made on CCFA medium. Plates were incubated anaerobically for 48hrs. The C. difficile isolates were identified by </span></em><em style=\"mso-bidi-font-style: normal;\"><span style=\"font-size: 10.0pt; font-family: \'Times New Roman\',\'serif\';\" lang=\"EN-IN\">colonial characteristic, fluorescence under UV light and positive Latex Agglutination test. The isolates were further characterized by gram reaction for cellular morphology, spore staining and various biochemical tests as described in Bergey\'s Manual of Systemetic Bacteriology, 2nd Edition (2001).</span></em></p>
<p class=\"MsoNormal\" style=\"margin-bottom: .0001pt; text-align: justify; text-justify: inter-ideograph; line-height: normal; mso-layout-grid-align: none; text-autospace: none;\"><strong><em style=\"mso-bidi-font-style: normal;\"><span style=\"font-size: 10.0pt; font-family: \'Times New Roman\',\'serif\'; color: #131313;\" lang=\"EN-IN\">Results: </span></em></strong><em style=\"mso-bidi-font-style: normal;\"><span style=\"font-size: 10.0pt; font-family: \'Times New Roman\',\'serif\'; color: #131313;\" lang=\"EN-IN\">271 diarrhoeal stool samples from hospitalized patients were investigated. Among these 176 were of male and 95 were of female patients. In total 16 isolates have been obtained from total of 271 clinical samples i.e. the isolation rate is 5.9% during six month. Among this C. difficile has been isolated from 10 males (62.5%) and 6 females (37.5%). A case of PMC has also been reported in present study.</span></em></p>
<p class=\"MsoNormal\" style=\"margin-bottom: .0001pt; text-align: justify; text-justify: inter-ideograph; line-height: normal; tab-stops: right 6.0in; mso-layout-grid-align: none; text-autospace: none;\"><strong><em style=\"mso-bidi-font-style: normal;\"><span style=\"font-size: 10.0pt; font-family: \'Times New Roman\',\'serif\'; color: #131313;\" lang=\"EN-IN\">Conclusion: </span></em></strong><em style=\"mso-bidi-font-style: normal;\"><span style=\"font-size: 10.0pt; font-family: \'Times New Roman\',\'serif\'; color: #131313;\" lang=\"EN-IN\">Though the rate of isolation of C. difficile was little lower than that reported in other Indian literatures, the present study shows that Clostridium difficile is prevalent in the South Gujarat Region of the Gujarat state of India and it should be considered to be a cause of antibiotic associated diarrhoea and found to be involved in causation of PMC too.</span></em></p>
<p class=\"MsoNormal\" style=\"margin-bottom: .0001pt; text-align: justify; text-justify: inter-ideograph; line-height: normal; tab-stops: right 6.0in; mso-layout-grid-align: none; text-autospace: none;\"><span style=\"font-size: 10.0pt; font-family: \'Times New Roman\',\'serif\'; color: #131313;\" lang=\"EN-IN\">&nbsp;</span></p>
<p class=\"MsoNormal\" style=\"margin-bottom: .0001pt; text-align: justify; text-justify: inter-ideograph; line-height: normal; tab-stops: right 6.0in; mso-layout-grid-align: none; text-autospace: none;\"><span style=\"font-size: 10.0pt; font-family: \'Times New Roman\',\'serif\'; color: #131313;\" lang=\"EN-IN\">Key words: </span><em><span style=\"font-size: 10.0pt; font-family: \'Times New Roman\',\'serif\'; mso-bidi-font-weight: bold;\" lang=\"EN-IN\">Clostridium difficile</span></em><span style=\"font-size: 10.0pt; font-family: \'Times New Roman\',\'serif\'; mso-bidi-font-weight: bold; mso-bidi-font-style: italic;\" lang=\"EN-IN\"> Infections</span><span style=\"font-size: 10.0pt; font-family: \'Times New Roman\',\'serif\'; color: #292526;\" lang=\"EN-IN\"> (CDI), Antibiotic-associated diarrhoea (AAD), Antibiotic-associated colitis (AAC), Pseudomembranous colitis (PMC), Toxic Megacolon, </span><em><span style=\"font-size: 10.0pt; font-family: \'Times New Roman\',\'serif\'; mso-bidi-font-weight: bold;\" lang=\"EN-IN\">Clostridium difficile</span></em><span style=\"font-size: 10.0pt; font-family: \'Times New Roman\',\'serif\'; color: #292526;\" lang=\"EN-IN\">-associated Diarrhoea</span><span style=\"font-size: 10.0pt; font-family: \'Times New Roman\',\'serif\'; color: #131313;\" lang=\"EN-IN\">(CDAD).</span></p>