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A Protocol to Characterize the Morphological Changes of Clostridium difficile in Response to Antibiotic Treatment
Published on: May 25, 2017
[Analysis of Clostridium difficile associated diarrhea in pediatric patients with antibiotic-associated diarrhea]
Insights
Clostridium difficile infection (CDI) is more common in children aged 1–12 with antibiotic-associated diarrhea (AAD). Metronidazole and vancomycin effectively treat CDI in pediatric patients.
Area of Science:
- Pediatric Infectious Diseases
- Microbiology
- Clinical Medicine
Background:
- Antibiotic-associated diarrhea (AAD) is a common complication in pediatric patients.
- Clostridium difficile infection (CDI) is a significant cause of AAD, particularly in hospitalized children.
- Understanding the incidence and effective treatment of CDI in pediatric AAD is crucial for improving patient outcomes.
Purpose of the Study:
- To determine the incidence of Clostridium difficile infection (CDI) in pediatric patients experiencing antibiotic-associated diarrhea (AAD).
- To analyze the effectiveness of different treatment regimens for CDI in pediatric patients with AAD.
- To compare CDI rates in pediatric AAD patients across different age groups and with healthy controls.
Main Methods:
- A retrospective study analyzed clinical data from 577 pediatric patients with AAD between January 2012 and January 2014.
- Patients were categorized into four age groups (0.25-1, >1-4, >4-12, >12-18 years) and compared with 220 healthy controls.
- CDI was diagnosed using C. Diff Quik Chek Complete (QCC) and BD GeneOhm™ C. Diff Assay (BD-PCR); AAD severity was graded, and treatment outcomes were analyzed.
Main Results:
- The incidence of CDI was significantly higher in AAD patients aged 1-4 years (22.0%) and 4-12 years (21.2%) compared to controls (4%).
- No significant difference in CDI rates was observed in the youngest (0.25-1 year) and oldest (>12-18 years) AAD groups compared to controls.
- Mild AAD cases showed no CDI, while general and severe AAD cases had higher CDI rates (47/176 and 81/116, respectively).
- Metronidazole and/or vancomycin treatment led to recovery in most CDI patients, with 16 cases of recurrent diarrhea observed.
Conclusions:
- Pediatric patients with antibiotic-associated diarrhea aged 1–12 years exhibit a higher incidence of Clostridium difficile infection compared to healthy children.
- Treatment with metronidazole and/or vancomycin is an effective therapeutic strategy for Clostridium difficile infection in pediatric patients.
- Severity of AAD correlates with CDI incidence, highlighting the need for targeted diagnostic and treatment approaches in this population.
Objective:
To analyze the incidence and treatment of Clostridium difficile infection (CDI) in pediatric patients with antibiotic-associated diarrhea (AAD).
Method:
Clinical data of totally 577 pediatric patients with AAD seen from January 2012 to January 2014 were collected; those children were divided according to age into 4 groups, 0.25 -1 year, >1 -4 years, >4 -12 years and >12 -18 years old groups, and 220 healthy children were enrolled as controls. CDI was tested by C. Diff Quik Chek Complete (QCC) and BD GeneOhm™ C. Diff Assay (BD-PCR) in all children, and the CDI incidence of four groups was added up. All pediatric patients with AAD were divided into mild, general and severe type according to different symptoms of diarrhea, and grading treatment, the general type and severe type of CDI children were treated with metronidazole and (or) vancomycin, afterwards, the results of grading treatment were analyzed.
Result:
The number of pediatric patients with AAD were 178, 177, 132 and 90 in 0. 25 - 1 year, > 1 -4 years, > 4 - 12 years and > 12 - 18 years old group, respectively. The positive rate of CDI (22. 0% (39/177)) in > 1 -4 years old AAD patients was very significantly higher compared to the controls (4% (4/91), P < 0. 001), the rate of CDI (21. 2% (28/132)) in > 4 - 12 years old AAD pediatric patients was significantly higher compared to the controls (4% (2/53), P = 0. 004), the rates of CDI in 0. 25 - 1 year and > 12 - 18years old AAD groups were not significantly different from that of the controls (P >0. 05). There were 285 mild type AAD children (no CDI children), 176 general type AAD children (including 47 CDI children), and 116 severe type AAD children (including 81 CDI children). After grading and symptomatic treatment, there were 16 recurrent diarrhea in 128 CDI patients (severe type AAD), and the rest recovered. Two cases were transferred for referral treatment, 2 cases died, and the rest 12 recurrent diarrhea children fully recovered after administration of metronidazole, vancomycin, probiotics and symptomatic treatment.
Conclusion:
The > 1 -12 years old AAD children had higher CDI rate than healthy children; administration of metronidazole and (or) vancomycin was effective for CD infection.
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