Related Experiment Videos
Colonization by Clostridium difficile in hospitalized children: risk factors and typification of the isolated strains
M Camorlinga1, O Muñoz, H Guiscafré
1Unidad de Investigación Clínica en Enfermedades Infecciosas y Parasitarias, Instituto Mexicano del Seguro Social, D.F.
Insights
Clostridium difficile colonization was studied in hospitalized children. Antibiotic use impacted colonization rates in infants, and pre-hospitalization strains were more toxigenic.
Area of Science:
- Microbiology
- Pediatric Infectious Diseases
- Epidemiology
Background:
- Clostridium difficile is a significant cause of hospital-acquired infections.
- Understanding colonization patterns in pediatric populations is crucial for infection control.
Purpose of the Study:
- To determine the frequency of Clostridium difficile colonization in hospitalized children under 15.
- To investigate risk factors such as antibiotic use and nutritional status.
- To characterize isolated Clostridium difficile strains based on toxigenicity and resistance.
Main Methods:
- Fecal samples were collected from 273 hospitalized children over 11 months.
- Colonization rates were analyzed by age group (neonates, <1 year, 1-5 years, 5-15 years).
- Risk factors (antibiotics, nutrition) and strain characteristics (toxigenicity, antibiotic sensitivity, phage/bacteriocin typing) were assessed.
Main Results:
- Colonization rates varied by age: 9.7% in <1 year, 8.3% in 1-5 years, 4.2% in 5-15 years.
- Antibiotic treatment significantly decreased colonization in children under one year.
- Pre-hospitalization strains were more toxigenic; specific resistotypes and phagobacteriocin types were associated with hospital-acquired strains.
Conclusions:
- Clostridium difficile colonization is present in hospitalized children, with higher rates in younger age groups.
- Antibiotic stewardship may be particularly important for preventing colonization in infants.
- Strain characterization reveals differences between community-acquired and hospital-acquired Clostridium difficile infections.
Abstract:
The frequency of colonization by Clostridium difficile in 273 hospitalized children under 15 years of age was studied. Feces were collected from patients attending the infectious disease service at the Pediatric Hospital IMSS, during a period of 11 months. No colonization was detected in 16 neonates; whereas 10 of 103 children (9.7%) under one year of age, 7 of 84 children (8.3%) from one to five years and 3 of 70 children (4.2%) from five to 15 years of age were colonized. The use of antibiotics and the nutritional state were studied as possible risk factors for colonization. The frequency of colonization was not influenced by the nutritional state, whereas the treatment with antibiotics decreased significantly the colonization in children under one year of age but not in those children over one year of age. In children under one year of age, the cytotoxin was more frequent in cases of diarrhea, and in those over one year no association was found. The 50 strains isolated from these children were classified according to: toxigenicity, sensitivity to antibiotics, phages and bacteriocins. Strains acquired before hospitalization were more toxigenic than those acquired intrahospital. Twelve resistotypes were detected; one of them (V) was more frequent in intrahospital strains. Ten phagobacteriocin types were found, and two of then (D and I) were present only in intrahospital strains. Using this classification scheme, it was found that eight patients were colonized with two different strains at the same time.