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Clostridium difficile in antibiotic associated pediatric diarrhea
1National Institute of Cholera and Enteric Disease, Beliaghata, Calcutta.
Insights
Clostridium difficile was rarely found in children with antibiotic-associated diarrhea. Strains from diarrhea cases were cytotoxic, unlike those from controls, suggesting it
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.
Abstract:
A case control study was carried out at the medical wards of Dr. B.C. Roy Memorial Hospital for Children, Calcutta, between January and September 1989. One hundred eleven hospitalized children up to the age of 5 years, receiving antibiotics for different medical problems, developed antibiotic associated diarrhea. Isolation of Clostridium difficile as sole pathogen was very low (3.6%) from these patients. Fecal samples of 111 case matched control children were also screened for C.difficile. Only 2.7% fecal samples of control children were positive for C.difficile. All the strains of C.difficile isolated from antibiotic associated diarrhea cases showed neutralisable cytotoxin in in vitro test. In contrast none of the strains isolated from control children showed cytotoxicity. This study suggests that C.difficile is not an important pathogen related to antibiotic associated diarrhea in children at this hospital.