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Is Clostridium difficile a pathogen in the newborn intensive care unit? A prospective evaluation
D Enad1, D Meislich, N L Brodsky
1Division of Neonatology, Albert Einstein Medical Center, Philadelphia, PA 19141, USA.
Summary
Clostridium difficile toxin A is common in newborn intensive care units. Infants with C. difficile toxin showed more gastrointestinal symptoms and longer hospital stays.
Area of Science:
- Neonatalogy
- Infectious Diseases
- Gastroenterology
Background:
- Clostridium difficile is a significant cause of infectious diarrhea.
- Newborn intensive care units (NICUs) are susceptible environments for pathogen transmission.
- Understanding C. difficile colonization and its impact in neonates is crucial.
Purpose of the Study:
- To determine the prevalence of Clostridium difficile toxin A in NICU patients.
- To investigate the association between C. difficile toxin and gastrointestinal symptoms in this vulnerable population.
Main Methods:
- A prospective, masked study analyzed stool specimens from NICU infants over 4 months.
- Enzyme immunoassay detected C. difficile toxin A.
- Clinical data, including stool frequency and GI symptoms, were collected daily.
Main Results:
- Over half of the 87 infants studied had C. difficile toxin-positive stools.
- Infants with C. difficile toxin were smaller, less mature, and had longer hospital stays (p < 0.001).
- Toxin-positive infants experienced significantly more days with frequent/abnormal stools and overall GI symptoms (p < 0.001).
Conclusions:
- Clostridium difficile toxin A is frequently present in NICU infants.
- C. difficile colonization is associated with an increased burden of gastrointestinal symptoms in neonates.