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Isolation of toxin producing Clostridium difficile from two children with oxacillin- and dicloxacillin-associated
Insights
Clostridium difficile (C. diff) infection can cause diarrhea in infants treated with penicillinase-resistant antibiotics like oxacillin and dicloxacillin. Stopping the antibiotic often resolves the C. diff diarrhea.
Area of Science:
- Microbiology
- Pediatric Gastroenterology
- Infectious Diseases
Background:
- Antibiotic-associated diarrhea (AAD) is a common complication in pediatric patients.
- Penicillinase-resistant penicillins, such as oxacillin and dicloxacillin, are frequently used in treating bacterial infections in children.
Observation:
- Two infants developed watery diarrhea with blood-tinged stools during or after treatment with oxacillin and dicloxacillin, respectively.
- Clostridium difficile was isolated from the stool of both infants.
- Diarrhea resolved shortly after antibiotic cessation in both cases.
Findings:
- Fecal samples from the affected infants contained preformed Clostridium difficile toxin.
- The toxigenicity of the C. difficile isolates was confirmed through tissue culture assay.
- The study demonstrates a direct link between C. difficile and antibiotic-induced diarrhea in infants.
Implications:
- Clostridium difficile should be considered in the differential diagnosis of diarrhea in infants receiving oxacillin or dicloxacillin.
- Judicious antibiotic use in pediatric populations is crucial to minimize the risk of C. diff infections.
- Early recognition and discontinuation of causative antibiotics can lead to rapid symptom resolution.
Abstract:
Clostridium difficile was isolated from the feces of two infants who had developed watery diarrhea with blood-tinged stain. One child suffered from diarrhea after five days of parenteral oxacillin therapy; the diarrhea subsided within three days of cessation of therapy. The other infant developed diarrhea following four days of oral dicloxacillin; the diarrhea subsided within two days of cessation of therapy. C difficile was no longer detectable in the stools of the infants at that time. Tissue culture assay showed the presence of preformed fecal toxin and demonstrated the toxigenicity of the fecal isolates of C. difficile and reference strains. These findings show that C difficile may play a role in diarrhea associated with oxacillin and dicloxacillin in children.