RELATIONSHIP BETWEEN tcdA AND tcdB GENES OF Clostridium difficile WITH DIARRHEA DURATION IN ELDERLY PATIENTS: AN IMMUNOSENESCENCE EFFECT

AIM: This novel research in Indonesia aimed to explore the relationship between tcdA and tcdB genes of Clostridium difficile with diarrhea duration in elderly patients. BACKGROUND: C. difficile spread by faecal-oral route has two main virulence factors namely TcdA encoded by the tcdA gene acts as an enterotoxin, pro-inflammatory and fluid accumulation; and TcdB encoded by the tcdB gene is cytotoxic, causes disruption of the actin cytoskeleton, and causes disruption of tight junctions in colon cells. It remains a major global threat responsible for a significant morbidity in elderly patients due to the immunosenescence effect with declining function of T-cell and B-cell. METHODS: This research design was a cohort prospective study with faecal samples collection from elderly diarrhea patients with comorbidities, history of antimicrobial consumption and chemotherapy in Denpasar City healthcare centres during 1 December 2022 until 30 September 2023 examined using real-time PCR method. RESULTS: 40 elderly diarrhea patients met the inclusion criteria. 8 samples (20%) were positive for 16s rRNA and there was no significant difference of diarrhea duration with negative samples (p=0.166). The relationship between the tcdA gene and the diarrhea duration could not be performed because all samples were negative as well as the relationship between the coexistence of tcdA and tcdB could not be performed. There was no significant difference between tcdB positive 3 (7.5%) and negative with diarrhea duration (p=0.739). CONCLUSIONS: There was no significant relationship between the presence of 16s rRNA and tcdB genes of C. difficile with diarrhea duration in elderly patients.