Related Experiment Videos
Cytotoxic effects of children's faeces: relation to diarrhoea due to Clostridium difficile and other enteric
E Kennedy1, V Burke, J Pearman
1Princess Margaret Children's Medical Research Foundation, Perth, Western Australia.
Insights
Faecal extracts from over half of children investigated showed cytotoxicity. This indicates the presence of various pathogens beyond Clostridium difficile and E. coli, necessitating further stool analysis.
Area of Science:
- Microbiology
- Clinical Medicine
- Pediatrics
Background:
- Cytotoxicity in fecal samples is a significant indicator of gastrointestinal distress.
- Identifying the causative agents of fecal cytotoxicity is crucial for effective treatment.
Purpose of the Study:
- To investigate the prevalence and causative agents of fecal cytotoxicity in children.
- To evaluate the diagnostic utility of cytotoxicity assays in identifying enteric pathogens.
Main Methods:
- Analysis of fecal extracts from 88 children undergoing microbiological investigation.
- Detection of cytotoxicity and identification of associated pathogens, including bacteria, viruses, and protozoa.
- Neutralization assays using antitoxin to identify specific cytotoxic agents.
Main Results:
- Cytotoxicity was detected in 54% (47/88) of children's fecal extracts.
- Commonly identified pathogens included Clostridium difficile and VTEC (V ertotoxigenic Escherichia coli).
- Cytotoxicity was also associated with Campylobacter jejuni, Salmonella spp., Shigella sonnei, Giardia lamblia, rotavirus, adenovirus, and poliovirus.
Conclusions:
- Fecal cytotoxicity is common in children and linked to a diverse range of enteric pathogens.
- Cytotoxicity assays can serve as an initial screening tool, prompting further investigation for specific pathogens like VTEC or viruses when antitoxin neutralization is negative.
Abstract:
Cytotoxicity of faecal extracts was demonstrated in 47 of 88 children (54%) referred for microbiological investigation of stools. Cytotoxic Clostridium difficile and vertotoxigenic Escherichia coli (VTEC) were the pathogens identified most commonly but cytotoxicity was also found in association with Campylobacter jejuni, Salmonella spp, Shigella sonnei, Giardia lamblia, rotavirus, adenovirus and poliovirus type 1 which had been acquired by oral immunization. In two patients, one of whom had cystic fibrosis, cytotoxicity of faecal extracts was associated with isolation of Pseudomonas aeruginosa. In five of 13 patients with diarrhoea and cytotoxic C. difficile, other pathogens were also present, in agreement with the view that C. difficile are more readily recovered when the intestinal flora have been altered by colonization with other micro-organisms. There was no correlation between previous treatment with antibiotics and isolation of C. difficile. Cytotoxicity neutralized by antitoxin, usually to C. sordellii, is used to detect cytotoxic C. difficile. We suggest that cytotoxicity not neutralized in this way should be an indication for further investigation of stools for the presence of other pathogens such as VTEC or viruses.