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Published on: December 10, 2016
Characteristics of Clostridioides difficile colonization in Ilamian children
M Sayyadi1, E Kouhsari2, G Kalvandi3
1Clinical Microbiology Research Center, Ilam University of Medical Sciences, Ilam, Iran.
Insights
Clostridioides difficile colonization in Iranian children was found to be 10%, with 37.5% of cases community-associated. Further studies are needed to understand the full burden of C. difficile disease in this population.
Area of Science:
- Microbiology
- Epidemiology
- Pediatrics
Background:
- Clostridioides difficile colonization is increasing in hospitalized children globally.
- The prevalence of Clostridioides difficile in Iranian children remains under-identified.
Purpose of the Study:
- To determine intestinal-carriage rates of Clostridioides difficile in the Ilamian pediatric population.
- To perform molecular characterization of Clostridioides difficile isolates.
Main Methods:
- Collected 80 stool samples from 40 children (<5 years) at hospitalization day 0 and day 5.
- Assessed samples for Clostridioides difficile, toxin A/B production, and molecular typing (ribotyping).
Main Results:
- Overall Clostridioides difficile colonization rate was 10% (8/80).
- Toxigenic Clostridioides difficile rate was 3.75% (3/80).
- Community-associated colonization accounted for 37.5% of cases, with distinct ribotypes identified.
Conclusions:
- Findings highlight the need for further epidemiological studies in Iranian children.
- Community-associated Clostridioides difficile colonization suggests current infection estimates may underestimate the disease burden.
Background:
The increasing colonization with Clostridioides difficile in paediatric hospitalized population is a well known event; however, its prevalence in Iranian children has not effectively been identified yet.
Objective:
The objective of this study was to determine the intestinal-carriage rates of C. difficile and molecular characterization of C. difficile in the Ilamian pediatric population from May 22, 2018, until September 22, 2018.
Materials And Methods:
Eighty samples were obtained from 40 children aged <5 years, at day 0 of their hospitalization (N=40 samples), to determine community-associated colonization, and then at day 5 days after hospitalization (N=40 samples), to determine healthcare associated colonization. The stool samples were examined for C. difficile, and isolated strains were evaluated for production of Clostridial toxins A/B and molecular characterizations.
Results:
The colonization rates of C. difficile and toxigenic C. difficile were 10% (8/80) and 3.75% (3/80), respectively. Based on the age group, the intestinal-carriage rates of C. difficile were 37.5, 50, and 12.5% in children ≤ 1, 1-3, and 3-5 years old, respectively. Our findings have revealed eight distinct ribotypes. Our findings have revealed eight distinct ribotypes of C. difficile isolates. Three out of 8 (37.5%) of C. difficile isolates were considered as community-associated colonization and belonged to ribotypes 7, 8, and 9. Conclusion. Our findings suggest the need of confirmation by further epidemiological studies in Iranian children. Given that the 37.5% of cases observed were community-associated, estimates of the incidence of C. difficile infections, that include only hospitalized children, may largely underestimate the burden of disease in children.
