Real-time PCR analysis of enteric pathogens from fecal samples of irritable bowel syndrome subjects

Fifteen IBS samples (17%) tested positive for Staphylococcus aureus with a thermonuclease (nuc) gene-targeting qPCR assay, whereas none of the healthy controls were positive for S. aureus (p < 0.05). The S. aureus -positive IBS samples were confirmed by sequencing of the PCR amplicons. Clostridium perfringens was detected from IBS and control groups with a similar frequency (13% and 17%, respectively) with α-toxin (plc) gene -targeting qPCR assay while none of the samples tested positive for the Cl. perfringens enterotoxin-encoding gene (cpe).The qPCR panel consisting of 12 assays for an extensive set of pathogenic microorganisms provides an efficient alternative to the conventional detection of gastrointestinal pathogens and could accelerate the initiation of targeted antibiotic therapy reducing the risk of post-infectious IBS (PI-IBS). S. aureus has not been previously reported to be associated with the onset of IBS. Although we discovered significant differences in the prevalence of S. aureus between the study groups, its importance in giving rise to IBS symptoms requires further studies.Irritable bowel syndrome (IBS) is a common multifactorial functional intestinal disorder of unknown etiology [1]. It is considered a major cause of abdominal discomfort and gut dysfunction worldwide with an estimated prevalence of 10% to 20% of the adult population, which makes it the most frequent diagnosis in gastroenterology [1-3]. Although not life-threatening, IBS is a major global health problem resulting in significant sensation of illness, poor quality of life, a high rate of work absenteeism and considerable health costs [4,5]. IBS is characterized by a variable combination of chronic and recurrent symptoms including abdominal pain or discomfort, irregular bowel movements, flatulence, and constipation or diarrhea [6]. According to the stool consistency, IBS subjects can be divided into three subcategories predominant in diarrhea (IBS-D), constipation (IBS-C) or alternati