Clostridium difficile in antibiotic associated pediatric diarrhea

Area of Science:

• Pediatric Infectious Diseases
• Microbiology
• Gastroenterology

Background:

• Antibiotic-associated diarrhea (AAD) is a common complication in hospitalized children.
• Clostridium difficile is a known cause of AAD, particularly in adults.
• The role of Clostridium difficile in pediatric AAD requires further investigation.

Purpose of the Study:

• To investigate the prevalence and role of Clostridium difficile in pediatric AAD.
• To compare the isolation rates and cytotoxicity of Clostridium difficile in children with and without AAD.

Main Methods:

• A case-control study was conducted involving 111 hospitalized children (up to 5 years) with AAD and 111 matched controls.
• Fecal samples were collected and screened for Clostridium difficile.
• Isolated Clostridium difficile strains were tested for in vitro cytotoxicity.

Main Results:

• Clostridium difficile was isolated from only 3.6% of children with AAD and 2.7% of controls.
• All Clostridium difficile strains from AAD cases exhibited neutralizable cytotoxin.
• No Clostridium difficile strains from control children showed cytotoxicity.

Conclusions:

• Clostridium difficile appears to be an uncommon cause of AAD in hospitalized children at this institution.
• The presence of cytotoxic Clostridium difficile strains in AAD cases warrants further study in pediatric populations.