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Clostridium difficile cytotoxin in a pediatric population
Insights
Clostridium difficile cytotoxin was found in 8.6% of pediatric patients, particularly in younger children and those with hospital or antibiotic-associated illnesses. These factors were significant independent risks for C. difficile infection.
Area of Science:
- Microbiology
- Pediatric Infectious Diseases
- Gastroenterology
Background:
- Clostridium difficile is a significant cause of infectious diarrhea in children.
- Cytotoxin production is a key virulence factor for C. difficile.
- Understanding risk factors for C. difficile cytotoxin in pediatric populations is crucial for effective management.
Purpose of the Study:
- To determine the prevalence of Clostridium difficile cytotoxin in pediatric stool samples.
- To identify risk factors associated with the presence of C. difficile cytotoxin in children.
- To correlate C. difficile cytotoxin detection with clinical diagnoses in pediatric patients.
Main Methods:
- Stool samples from 208 pediatric patients were analyzed for Clostridium difficile cytotoxin.
- Data on patient age, hospitalization, and antibiotic use were collected.
- Clinical diagnoses were reviewed for correlation with cytotoxin detection.
Main Results:
- Clostridium difficile cytotoxin was detected in 8.6% of pediatric patients.
- Cytotoxin was more prevalent in younger children (median age 11 months).
- Hospital-associated illness (17%) and antibiotic-associated illness (18%) were linked to higher cytotoxin detection rates.
Conclusions:
- Younger age, hospitalization, and antibiotic use are significant independent risk factors for C. difficile cytotoxin in pediatric patients.
- C. difficile cytotoxin can be associated with a spectrum of clinical presentations, from colitis to asymptomatic carriage.
- Routine laboratory assays for C. difficile cytotoxin are valuable in pediatric settings.
Abstract:
Assays for cytotoxin of Clostridium difficile were performed on stool samples submitted to the laboratory for routine microbiologic study. Cytotoxin was recovered from 8.6% of 208 pediatric patients studied. Cytotoxin was identified significantly more often in younger patients (median age, 11 months) and in those with hospital-associated illness (17%) and antibiotic-associated illness (18%). Hospitalization and antibiotic use were significant independent risk factors. Clinical diagnoses in patients with C difficile cytotoxin included classic pseudomembranous colitis, acute self-resolving diarrheal syndrome, chronic diarrhea with failure to thrive, infant botulism, and asymptomatic carriage.