Acta microbiologica et immunologica Hungarica最新文献

{"title":"Effects of concurrent Helicobacter pylori infection and small intestinal bacterial overgrowth on the gut microbiota and metabolic profiles: A multi-omics study.","authors":"Yu-Cheng Zhu, Yan Deng, Jia-Qi Zeng","doi":"10.1556/030.2026.02894","DOIUrl":"10.1556/030.2026.02894","url":null,"abstract":"<p><p>This study investigated the synergistic effects of Helicobacter pylori (Hp) infection and small intestinal bacterial overgrowth (SIBO) on the gut microbiota structure and metabolic profiles and elucidate the underlying pathophysiological mechanisms. Forty-two patients with gastrointestinal symptoms were recruited and assigned to group A (Hp+ SIBO+), B (Hp+ SIBO-), C (Hp- SIBO+), or D (Hp- SIBO-) based on their Hp infection and SIBO status. Fecal samples were collected for metagenomic sequencing and untargeted metabolomic analysis. The associations between microbiota and metabolites were evaluated using alpha/beta diversity analysis, differential species screening, metabolite identification, and Procrustes/Spearman correlation analysis. Neither Hp infection nor SIBO significantly altered the alpha or beta diversity of the gut microbiota (both P > 0.05). However, specific shifts in microbial abundance were observed. Specifically, the abundance of short-chain fatty acid-producing bacteria such as Megamonas was significantly decreased in the SIBO+ groups. Metabolomic analysis revealed significant enrichment of inflammatory metabolites (e.g., prostaglandin derivatives) in group A, disordered bile acid conjugates (e.g., chenodeoxycholylisoleucine) and nucleotide metabolism in SIBO+ groups, and abnormal lipid/carbohydrate metabolism pathways in Hp+ groups. Multi-omics integration analysis indicated a strong coupling between the microbial structure and metabolic profiles (Procrustes analysis, P < 0.05). In group A, the abundance of Faecalibacterium and Hominenteromicrobium was negatively correlated with bile acid levels, suggesting impaired bile acid transformation. Hp infection and SIBO might synergistically exacerbate gut ecological and metabolic disorders by reshaping specific microbiota and metabolic networks (enhanced inflammatory response, disrupted bile acid circulation). Their co-occurrence produces additive effects, which could explain the aggravated clinical symptoms. This study provides a theoretical basis for interventions targeting microbiota-metabolite interactions, such as probiotics and bile acid modulators.</p>","PeriodicalId":7119,"journal":{"name":"Acta microbiologica et immunologica Hungarica","volume":" ","pages":"201-210"},"PeriodicalIF":1.5,"publicationDate":"2026-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147697101","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Multi-omics analysis of gut microbiota and gene expression reveals that TBK1 promotes colorectal tumorigenesis by activating glycolysis.","authors":"Anqing Luo, Jian Wang, Yizhou Yao, Xishan Zhang, Xinguo Zhu","doi":"10.1556/030.2026.02853","DOIUrl":"10.1556/030.2026.02853","url":null,"abstract":"<p><p>Colorectal cancer (CRC) is a prevalent malignancy with intricate connections to gut microbiota (GM) dysbiosis, though the specific mechanisms linking microbiota-induced gene expression changes to CRC progression remain unclear. This study employed a multi-omics approach to investigate the interplay between GM alterations and host gene expression in CRC. C57BL/6J male mice were used to establish CRC models via dextran sulfate sodium (DSS)/azoxymethane (AOM) induction. 16S rRNA sequencing was performed to characterize GM changes in CRC mouse models, revealing dysbiosis characterized by reduced Akkermansia muciniphila (Akkermansia) and elevated Desulfovibrio desulfuricans (Desulfovibrio) abundance. Transcriptomic analysis following microbiota transplantation identified significant upregulation of TANK-binding kinase 1 (TBK1) in CRC-associated microbiota recipients. In vitro experiments utilizing CRC cell models demonstrated that TBK1 overexpression activated glycolysis, as evidenced by increased extracellular acidification rate, lactate production, and elevated expression of glycolytic enzymes hexokinase 2 (HK2) and pyruvate dehydrogenase kinase 1 (PDK1). Functionally, TBK1 promoted cell proliferation and colony formation while inhibiting apoptosis, which were attenuated by the glycolytic inhibitor 2-deoxy-D-glucose. These findings establish TBK1 as a critical mediator linking GM dysbiosis to metabolic reprogramming in CRC, suggesting that targeting the TBK1-glycolysis axis may represent a promising therapeutic strategy for delaying CRC progression.</p>","PeriodicalId":7119,"journal":{"name":"Acta microbiologica et immunologica Hungarica","volume":" ","pages":"416-425"},"PeriodicalIF":1.5,"publicationDate":"2026-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147697182","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Nocardia bacteremia: A seven-year retrospective analysis of reported cases.","authors":"Sofia Maraki, Viktoria Eirini Mavromanolaki, Evangelia Iliaki-Giannakoudaki, Anna Kasimati","doi":"10.1556/030.2026.02898","DOIUrl":"10.1556/030.2026.02898","url":null,"abstract":"<p><p>Nocardia species can cause serious infections, especially in immunocompromised individuals, though it can also affect immunocompetent patients. Bacteremia due to this organism is always clinically significant and is associated with high mortality rates. We reviewed all cases of Nocardia bacteremia published in medical literature since 2019. A total of 28 studies providing data for 29 patients were included. Among all patients, 69% were male; the median age was 60 years. Overall, 23 (79.3%) patients were immunosuppressed [immunosuppressive treatment (73.9%), malignancies (34.8%), transplantation (26.1%), and autoimmune diseases (26.1%)]. Pulmonary involvement was the most frequent concomitant site of infection. Fever, cough, dyspnea, shortness of breath, and fatigue were the most commonly encountered symptoms. Seven patients (24.1%) had concurrent infections at the time of Nocardia bacteremia. Most isolates were identified using matrix-assisted laser desorption/ionization time-of-flight mass spectrometry (MALDI-TOF MS). N. farcinica was the most commonly identified species (44.8%), followed by N. cyricigeorgica (25%), and N. nova (10.3%). High rates of resistance were observed for amoxicillin/clavulanic acid and ciprofloxacin (57.1% for each), clindamycin (42.9%), cefotaxime (21.4%) and imipenem (21.4%). All 14 isolates tested for trimethoprim/sulfamethoxazole (TMP/SMX) and linezolid were susceptible. The median total duration of treatment was 7.2 months. TMP/SMX was used in 78.6% of patients, carbapenems in 60.7% and linezolid in 35.7%. Mortality rate was significant (34.5%). Nocardia bacteremia is a rare but serious disseminated form of nocardiosis. Early diagnosis and prompt aggressive treatment, typically with a combination of antibiotics and long-term therapy are crucial for improving outcomes.</p>","PeriodicalId":7119,"journal":{"name":"Acta microbiologica et immunologica Hungarica","volume":" ","pages":"131-142"},"PeriodicalIF":1.5,"publicationDate":"2026-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147607746","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Plasma endotoxin level independently predicts unfavorable 90-day outcome in acute ischemic stroke patients with type 2 diabetes mellitus.","authors":"Xiaoquan Li, Jia Liu","doi":"10.1556/030.2026.02887","DOIUrl":"10.1556/030.2026.02887","url":null,"abstract":"<p><p>The prognostic utility of plasma endotoxemia, marked by elevated lipopolysaccharide (LPS) and often associated with gut barrier dysfunction, remains undefined in acute ischemic stroke (AIS) patients with type 2 diabetes. In this single-center prospective cohort of 300 AIS patients with diabetes, we measured early admission plasma LPS and assessed its correlation with stroke severity and inflammatory markers, and its independent association with 90-day unfavorable functional outcome (modified Rankin Scale 3-6). Compared to the good outcome group, patients with poor outcomes had significantly higher LPS levels. Log-transformed LPS levels positively correlated with baseline NIHSS score, high-sensitivity C-reactive protein, and white blood cell count. After multivariable adjustment for age, NIHSS, HbA1c, atrial fibrillation, estimated glomerular filtration rate, and other covariates, each standard deviation increase in log-LPS was independently associated with an increased risk of 90-day unfavorable outcome (odds ratio 1.86, 95% CI 1.39-2.48). A clear dose-response relationship was observed, with the risk of poor outcome and mortality rising across LPS quartiles. Adding LPS to a basic clinical prediction model improved the area under the curve from 0.79 to 0.83, enhanced risk reclassification, and provided greater net clinical benefit across a range of decision thresholds. In conclusion, early admission plasma endotoxemia is an independent predictor of 90-day functional outcome in AIS patients with diabetes and improves conventional risk stratification. This finding positions LPS as a clinically accessible biomarker that is associated with poor recovery in acute ischemic stroke.</p>","PeriodicalId":7119,"journal":{"name":"Acta microbiologica et immunologica Hungarica","volume":" ","pages":"245-254"},"PeriodicalIF":1.5,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147589205","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Emergence of ciprofloxacin-resistant Neisseria meningitidis ST-175 in Tunisia: Clinical case description and genomic characterization.","authors":"Sana Ferjani, Lamia Kanzari, Aymen Zoubli, Zaineb Hamzaoui, Khaoula Mefteh, Hanen Smaoui, Sarra Jouini, Ilhem Boutiba Ben Boubaker","doi":"10.1556/030.2026.02923","DOIUrl":"10.1556/030.2026.02923","url":null,"abstract":"<p><p>We describe a case of meningococcal bloodstream infection complicated by purpura fulminans in a 49-year-old woman in Tunisia in May 2025, caused by a ciprofloxacin-resistant Neisseria meningitidis. The patient presented with rapidly progressive purpura and septic shock requiring intensive care and empirical cefotaxime therapy. Blood cultures, molecular testing, and whole-genome sequencing (WGS) were investigated to characterize the N. meningitidis isolate. The strain was non-groupable and belonged to ST-175 (cc175), with BAST profile 3645 and a MenDeVAR Index indicating insufficient evidence for vaccine coverage. WGS identified penA mutations (F504L, A510V, I515V, H541N, I566V) associated with reduced amoxicillin susceptibility and a gyrA T91I mutation conferring ciprofloxacin resistance. Comparative genomic analysis showed close relatedness to European isolates, representing the first genomic documentation of cc175 in Tunisia. This case underscores the value of genomic analysis for detecting emerging antimicrobial resistance and monitoring unusual meningococcal lineages in adult patients.</p>","PeriodicalId":7119,"journal":{"name":"Acta microbiologica et immunologica Hungarica","volume":" ","pages":"182-185"},"PeriodicalIF":1.5,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147589254","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Stenotrophomonas maltophilia infections: Current status on first-line therapy and other treatment options.","authors":"Nisanart Charoenlap, Suleepon Poomchuchit, Skorn Mongkolsuk, Paiboon Vattanaviboon","doi":"10.1556/030.2026.02883","DOIUrl":"10.1556/030.2026.02883","url":null,"abstract":"<p><p>Stenotrophomonas maltophilia is an opportunistic pathogen primarily associated with hospital-acquired infections, particularly in individuals who are immunocompromised. S. maltophilia infections pose a significant clinical challenge due to the bacterium's sophisticated intrinsic and acquired mechanisms, which render it naturally multidrug resistant. The management of such infections is thus difficult, as the availability of effective therapeutic agents is limited. Antibiotic therapy options include co-trimoxazole, minocycline, tigecycline, levofloxacin, cefiderocol, and ceftazidime-avibactam. Co-trimoxazole, which comprises a synergistic combination of trimethoprim and sulfamethoxazole, remains the recommended first-line therapy for S. maltophilia infections. In this review, we critically evaluate the current evidence on the efficacy of co-trimoxazole against S. maltophilia. The present global prevalence of co-trimoxazole resistance in S. maltophilia clinical isolates varies from <5% to approximately 44%, raising concerns about its long-term reliability. Resistance to co-trimoxazole arises through several mechanisms. Horizontal gene transfer can introduce sul genes, which encode sulfonamide-insensitive dihydropteroate synthase, or dfrA genes, which encode trimethoprim-insensitive dihydrofolate reductase. Both enzymes function within the folate biosynthesis pathway, and their expression directly confers co-trimoxazole resistance. S. maltophilia can also acquire co-trimoxazole resistance through genetic mutations. The overexpression of efflux systems such as SmeVWX and SmeDEF, contributes to high-level resistance to co-trimoxazole, often triggered by mutations in the transcriptional regulators. Resistant strains frequently emerge due to improper antimicrobial use, as environmental antibiotic residues can act as selection pressure, facilitating the emergence and persistence of resistant strains. Despite these challenges, co-trimoxazole continues to demonstrate substantial clinical utility. It remains effective in many settings, either as monotherapy or in combination with other antibiotics such as minocycline, tigecycline, cefiderocol, or levofloxacin, and often achieves favorable outcomes.</p>","PeriodicalId":7119,"journal":{"name":"Acta microbiologica et immunologica Hungarica","volume":" ","pages":"119-130"},"PeriodicalIF":1.5,"publicationDate":"2026-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147490538","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Safety of discontinuing contact precautions in patients with multidrug-resistant bacterial infection or colonization.","authors":"Muhammed Cihan Işık, Gülçin Telli Dizman, Nur Dilek Gül, İlknur Tekin Demir, Hanife Aytaç Ak, Pınar Zarakolu, Gökhan Metan","doi":"10.1556/030.2026.02900","DOIUrl":"10.1556/030.2026.02900","url":null,"abstract":"<p><p>Lack of standardized criteria for discontinuing contact precautions (CP) in patients colonized or infected with multidrug-resistant bacteria (MDRB) can prolong isolation and strain healthcare resources. This retrospective cohort study aimed to assess the safety of a protocol-guided CP discontinuation strategy and identify risk factors for MDRB reacquisition. The study evaluated 88 adult patients under CP who met an institutional protocol for CP discontinuation between 2018 and 2023. The protocol required: no active infection; no antibiotic use in the preceding seven days; no drains or open wounds; no diarrhea; a negative culture from the initial site of MDRB identification; and a subsequent confirmatory negative screening (culture and/or PCR). Patients were followed for one year after CP discontinuation to assess MDRB reacquisition, defined as a new positive specimen for the same species. Potential risk factors for reacquisition were analyzed using multivariable Cox regression. At the one-year follow-up, MDRB reacquisition occurred in 17% (15/88) of patients. The reacquired pathogens included carbapenem-resistant Enterobacterales (9/50), methicillin-resistant Staphylococcus aureus (6/30), and vancomycin-resistant Enterococcus spp. (0/8). Independent risk factors for reacquisition were chronic obstructive pulmonary disease (HR 5.76, 95% CI 1.34-24.81), shorter duration of isolation (HR 0.98 per day, 95% CI 0.97-0.99), frequent hospitalizations (HR 1.75 per admission, 95% CI 1.07-2.88), and central venous catheterization (HR 13.04, 95% CI 2.63-64.69). Protocol-guided CP discontinuation was associated with a low rate of MDRB reacquisition and appears safe in appropriately selected patients. This approach may reduce unnecessary isolation in eligible patients, though high-risk individuals require closer monitoring.</p>","PeriodicalId":7119,"journal":{"name":"Acta microbiologica et immunologica Hungarica","volume":" ","pages":"194-200"},"PeriodicalIF":1.5,"publicationDate":"2026-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147490596","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Diagnostic value of metagenomic next-generation sequencing on bronchoalveolar lavage fluid via radial endobronchial ultrasound for peripheral pulmonary infectious lesions: A retrospective cohort study.","authors":"Mengge Wen, Xiaochun Wang","doi":"10.1556/030.2026.02865","DOIUrl":"10.1556/030.2026.02865","url":null,"abstract":"<p><p>The etiological diagnosis of peripheral pulmonary infectious lesions (PPILs) is challenging due to the limitations of conventional microbiological methods (CMMs). This study aimed to evaluate the diagnostic value of metagenomic next-generation sequencing (mNGS) performed on bronchoalveolar lavage fluid (BALF) obtained via radial endobronchial ultrasound (r-EBUS) for PPILs. This single-center, retrospective diagnostic accuracy study enrolled 110 patients with PPILs who underwent r-EBUS-guided BALF between January 2023 and December 2024. BALF samples were subjected to both mNGS and CMMs. The final diagnosis was established by two senior pulmonologists based on a comprehensive review of all clinical data. The diagnostic performance of mNGS and CMMs was compared against this final diagnosis. A definitive diagnosis was established in all 110 patients, with 68 cases identified as infectious lesions and 42 as non-infectious. The sensitivity of mNGS for detecting pathogens in infectious lesions was significantly higher than that of CMMs (89.7% vs. 47.1%, P < 0.001). The overall diagnostic accuracy of mNGS was also superior to CMMs (90.9% vs. 66.4%, P < 0.001). Among patients with positive mNGS results, clinical management was altered in 73.8% of cases based on the findings. mNGS uniquely identified pathogens in 31 cases that were missed by CMMs. For patients with PPILs, mNGS analysis of BALF samples obtained via r-EBUS demonstrates significantly greater diagnostic sensitivity and accuracy than conventional methods. This approach has a substantial impact on clinical decision-making, facilitating targeted antimicrobial therapy and representing a powerful tool in the diagnostic workflow for peripheral pulmonary infections.</p>","PeriodicalId":7119,"journal":{"name":"Acta microbiologica et immunologica Hungarica","volume":" ","pages":"211-222"},"PeriodicalIF":1.5,"publicationDate":"2026-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147455283","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Detection of blaNDM-1, blaOXA-23, and blaOXA-58 positive Acinetobacter baumannii in an intensive care unit in Brazil.","authors":"Rafael Thiago Pereira da Silva, Igor Vasconcelos Rocha, Paula Mariana Salgueiro de Souza, Tainara Fernandes Dantas, Amanda Vieira de Barros, Henrique Douglas Melo Coutinho, Maria Betânia Melo de Oliveira","doi":"10.1556/030.2026.02879","DOIUrl":"10.1556/030.2026.02879","url":null,"abstract":"<p><p>This study reports on a multidrug-resistant (MDR) Acinetobacter baumannii isolate identified through microbiological surveillance of rectal swabs from a patient admitted to an intensive care unit (ICU) of a public hospital in Pernambuco, Brazil, in 2022. Bacterial identification and antimicrobial susceptibility testing were performed using the VITEK® automated system, and species confirmation was carried out by matrix-assisted laser desorption/ionization time-of-flight mass spectrometry (MALDI-TOF MS). The presence of antibiotic resistance genes, including blaKPC, blaIMP, blaVIM, blaNDM, blaSPM, blaOXA-23, blaOXA-24, blaOXA-51, blaOXA-58, and mcr-1 to mcr-10, was investigated by polymerase chain reaction (PCR). The A. baumannii isolate exhibited resistance to all tested antimicrobials and demonstrated strong biofilm-forming capacity. Molecular analysis revealed the presence of blaNDM-1, blaOXA-23 and blaOXA-58 genes, representing a concerning genetic combination associated with carbapenem resistance. The A. baumannii isolate exhibited resistance to polymyxin B but lacked mcr-1 to mcr-10 genes. Asymptomatic colonization of MDR A. baumannii in a patient at ICU underscores the risk of possible infection that may become invasive. These findings highlight the importance of continuous microbiological surveillance to monitor the dissemination of MDR pathogens in hospital environments.</p>","PeriodicalId":7119,"journal":{"name":"Acta microbiologica et immunologica Hungarica","volume":" ","pages":"71-77"},"PeriodicalIF":1.5,"publicationDate":"2026-03-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147324127","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ribotype distribution of Clostridioides difficile isolated from patients with diarrhea in Ahvaz, Iran.","authors":"Mohammad Hashemzadeh, Kobra Kiarasi Behdarvand, Effat Abbasi Montazeri, Zahra Farshad Zadeh, Roohangiz Nashibi","doi":"10.1556/030.2026.02870","DOIUrl":"10.1556/030.2026.02870","url":null,"abstract":"<p><p>Diarrhea is one of the leading infectious diseases, causing the greatest health burden in most developing countries, with Clostridioides difficile-associated diarrhea being the primary cause of hospital-acquired diarrhea. Given the demonstrated mortality associated with diarrhea and its consequences and the significant association between C. difficile and diarrhea, this study aimed to investigate the ribotype distribution of C. difficile isolated from patients with diarrhea in Ahvaz, Iran. From May to November of 2025, 50 patients with diarrhea were admitted to the hospital. The tpi gene was amplified by the PCR method to detect C. difficile isolates. The other method was a real-time PCR to identify C. difficile isolates from stool samples. The two diagnostic methods applied in this study were comparable. PCR was used to investigate the presence of C. difficile toxin genes. Among the 12 positive isolates, the tcdA gene was detected in 6/12 (50%) of the isolates. Additionally, 6/12 (50%) of the isolates was detected the tcdB gene. 1/12 C. difficile isolate was resistant to vancomycin, but all isolates were susceptible to metronidazole and fidaxomicin. Ribotype 001 was the most dominant (n = 4, 33.3%), with ribotype 126 representing the second most common at 25% (n = 3). Ribotype 070 (n = 2, 16.7%), 084 (n = 2, 16.7%), and 078 (n = 1, 8.3%) were detected at lower frequencies. The detection of toxin-producing genes in some isolates is also an indication of the bacterium's significant virulence potential. The findings indicated the need for ongoing surveillance of C. difficile and the antibiotic resistance characteristics in hospital settings.</p>","PeriodicalId":7119,"journal":{"name":"Acta microbiologica et immunologica Hungarica","volume":" ","pages":"86-94"},"PeriodicalIF":1.5,"publicationDate":"2026-03-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147324142","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}