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Community-acquired Clostridium difficile infection in children: A retrospective study

Abstract Background Community acquired- Clostridium difficile infection (CDI) has increased also in children in the last years. Aims To determine the incidence of community-acquired CDI and to understand whether Clostridium difficile could be considered a symptom-triggering pathogen in infants. Meth...

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Published in:Digestive and liver disease 2015-10, Vol.47 (10), p.842-846
Main Authors: Borali, Elena, Ortisi, Giuseppe, Moretti, Chiara, Stacul, Elisabetta Francesca, Lipreri, Rita, Gesu, Giovanni Pietro, De Giacomo, Costantino
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cited_by cdi_FETCH-LOGICAL-c478t-20906f4ff73c81dd18642ffe42831fc52992462115ce589c821049fd444fd3023
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container_end_page 846
container_issue 10
container_start_page 842
container_title Digestive and liver disease
container_volume 47
creator Borali, Elena
Ortisi, Giuseppe
Moretti, Chiara
Stacul, Elisabetta Francesca
Lipreri, Rita
Gesu, Giovanni Pietro
De Giacomo, Costantino
description Abstract Background Community acquired- Clostridium difficile infection (CDI) has increased also in children in the last years. Aims To determine the incidence of community-acquired CDI and to understand whether Clostridium difficile could be considered a symptom-triggering pathogen in infants. Methods A five-year retrospective analysis (January 2007–December 2011) of faecal specimens from 124 children hospitalized in the Niguarda Ca’ Granda Hospital for prolonged or muco-haemorrhagic diarrhoea was carried out. Stool samples were evaluated for common infective causes of diarrhoea and for Clostridium difficile toxins. Patients with and without CDI were compared for clinical characteristics and known risk factors for infection. Results Twenty-two children with CDI were identified in 5 years. An increased incidence of community-acquired CDI was observed, ranging from 0.75 per 1000 hospitalizations in 2007 to 9.8 per 1000 hospitalizations in 2011. Antimicrobial treatment was successful in all 19 children in whom it was administered; 8/22 CDI-positive children were younger than 2 years. No statistically significant differences in clinical presentation were observed between patients with and without CDI, nor in patients with and without risk factors for CDI. Conclusions Our study shows that Clostridium difficile infection is increasing and suggests a possible pathogenic role in the first 2 years of life.
doi_str_mv 10.1016/j.dld.2015.06.002
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Aims To determine the incidence of community-acquired CDI and to understand whether Clostridium difficile could be considered a symptom-triggering pathogen in infants. Methods A five-year retrospective analysis (January 2007–December 2011) of faecal specimens from 124 children hospitalized in the Niguarda Ca’ Granda Hospital for prolonged or muco-haemorrhagic diarrhoea was carried out. Stool samples were evaluated for common infective causes of diarrhoea and for Clostridium difficile toxins. Patients with and without CDI were compared for clinical characteristics and known risk factors for infection. Results Twenty-two children with CDI were identified in 5 years. An increased incidence of community-acquired CDI was observed, ranging from 0.75 per 1000 hospitalizations in 2007 to 9.8 per 1000 hospitalizations in 2011. Antimicrobial treatment was successful in all 19 children in whom it was administered; 8/22 CDI-positive children were younger than 2 years. No statistically significant differences in clinical presentation were observed between patients with and without CDI, nor in patients with and without risk factors for CDI. Conclusions Our study shows that Clostridium difficile infection is increasing and suggests a possible pathogenic role in the first 2 years of life.</description><identifier>ISSN: 1590-8658</identifier><identifier>EISSN: 1878-3562</identifier><identifier>DOI: 10.1016/j.dld.2015.06.002</identifier><identifier>PMID: 26141927</identifier><language>eng</language><publisher>Netherlands: Elsevier Ltd</publisher><subject>Adolescent ; Age Factors ; Anti-Infective Agents - therapeutic use ; Child ; Child, Preschool ; Clostridium difficile ; Clostridium Infections - drug therapy ; Clostridium Infections - epidemiology ; Community-Acquired Infections - drug therapy ; Community-Acquired Infections - epidemiology ; Diarrhea - epidemiology ; Diarrhea - microbiology ; Diarrhoea ; Female ; Gastroenterology and Hepatology ; Hospitalization ; Humans ; Incidence ; Infant ; Infectious disease ; Male ; Retrospective Studies ; Risk Factors</subject><ispartof>Digestive and liver disease, 2015-10, Vol.47 (10), p.842-846</ispartof><rights>Editrice Gastroenterologica Italiana S.r.l.</rights><rights>2015 Editrice Gastroenterologica Italiana S.r.l.</rights><rights>Copyright © 2015 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c478t-20906f4ff73c81dd18642ffe42831fc52992462115ce589c821049fd444fd3023</citedby><cites>FETCH-LOGICAL-c478t-20906f4ff73c81dd18642ffe42831fc52992462115ce589c821049fd444fd3023</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,27924,27925</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/26141927$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Borali, Elena</creatorcontrib><creatorcontrib>Ortisi, Giuseppe</creatorcontrib><creatorcontrib>Moretti, Chiara</creatorcontrib><creatorcontrib>Stacul, Elisabetta Francesca</creatorcontrib><creatorcontrib>Lipreri, Rita</creatorcontrib><creatorcontrib>Gesu, Giovanni Pietro</creatorcontrib><creatorcontrib>De Giacomo, Costantino</creatorcontrib><title>Community-acquired Clostridium difficile infection in children: A retrospective study</title><title>Digestive and liver disease</title><addtitle>Dig Liver Dis</addtitle><description>Abstract Background Community acquired- Clostridium difficile infection (CDI) has increased also in children in the last years. Aims To determine the incidence of community-acquired CDI and to understand whether Clostridium difficile could be considered a symptom-triggering pathogen in infants. Methods A five-year retrospective analysis (January 2007–December 2011) of faecal specimens from 124 children hospitalized in the Niguarda Ca’ Granda Hospital for prolonged or muco-haemorrhagic diarrhoea was carried out. Stool samples were evaluated for common infective causes of diarrhoea and for Clostridium difficile toxins. Patients with and without CDI were compared for clinical characteristics and known risk factors for infection. Results Twenty-two children with CDI were identified in 5 years. An increased incidence of community-acquired CDI was observed, ranging from 0.75 per 1000 hospitalizations in 2007 to 9.8 per 1000 hospitalizations in 2011. Antimicrobial treatment was successful in all 19 children in whom it was administered; 8/22 CDI-positive children were younger than 2 years. No statistically significant differences in clinical presentation were observed between patients with and without CDI, nor in patients with and without risk factors for CDI. 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Ortisi, Giuseppe ; Moretti, Chiara ; Stacul, Elisabetta Francesca ; Lipreri, Rita ; Gesu, Giovanni Pietro ; De Giacomo, Costantino</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c478t-20906f4ff73c81dd18642ffe42831fc52992462115ce589c821049fd444fd3023</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2015</creationdate><topic>Adolescent</topic><topic>Age Factors</topic><topic>Anti-Infective Agents - therapeutic use</topic><topic>Child</topic><topic>Child, Preschool</topic><topic>Clostridium difficile</topic><topic>Clostridium Infections - drug therapy</topic><topic>Clostridium Infections - epidemiology</topic><topic>Community-Acquired Infections - drug therapy</topic><topic>Community-Acquired Infections - epidemiology</topic><topic>Diarrhea - epidemiology</topic><topic>Diarrhea - microbiology</topic><topic>Diarrhoea</topic><topic>Female</topic><topic>Gastroenterology and Hepatology</topic><topic>Hospitalization</topic><topic>Humans</topic><topic>Incidence</topic><topic>Infant</topic><topic>Infectious disease</topic><topic>Male</topic><topic>Retrospective Studies</topic><topic>Risk Factors</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Borali, Elena</creatorcontrib><creatorcontrib>Ortisi, Giuseppe</creatorcontrib><creatorcontrib>Moretti, Chiara</creatorcontrib><creatorcontrib>Stacul, Elisabetta Francesca</creatorcontrib><creatorcontrib>Lipreri, Rita</creatorcontrib><creatorcontrib>Gesu, Giovanni Pietro</creatorcontrib><creatorcontrib>De Giacomo, Costantino</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Digestive and liver disease</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Borali, Elena</au><au>Ortisi, Giuseppe</au><au>Moretti, Chiara</au><au>Stacul, Elisabetta Francesca</au><au>Lipreri, Rita</au><au>Gesu, Giovanni Pietro</au><au>De Giacomo, Costantino</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Community-acquired Clostridium difficile infection in children: A retrospective study</atitle><jtitle>Digestive and liver disease</jtitle><addtitle>Dig Liver Dis</addtitle><date>2015-10-01</date><risdate>2015</risdate><volume>47</volume><issue>10</issue><spage>842</spage><epage>846</epage><pages>842-846</pages><issn>1590-8658</issn><eissn>1878-3562</eissn><abstract>Abstract Background Community acquired- Clostridium difficile infection (CDI) has increased also in children in the last years. Aims To determine the incidence of community-acquired CDI and to understand whether Clostridium difficile could be considered a symptom-triggering pathogen in infants. Methods A five-year retrospective analysis (January 2007–December 2011) of faecal specimens from 124 children hospitalized in the Niguarda Ca’ Granda Hospital for prolonged or muco-haemorrhagic diarrhoea was carried out. Stool samples were evaluated for common infective causes of diarrhoea and for Clostridium difficile toxins. Patients with and without CDI were compared for clinical characteristics and known risk factors for infection. Results Twenty-two children with CDI were identified in 5 years. An increased incidence of community-acquired CDI was observed, ranging from 0.75 per 1000 hospitalizations in 2007 to 9.8 per 1000 hospitalizations in 2011. Antimicrobial treatment was successful in all 19 children in whom it was administered; 8/22 CDI-positive children were younger than 2 years. 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subjects Adolescent
Age Factors
Anti-Infective Agents - therapeutic use
Child
Child, Preschool
Clostridium difficile
Clostridium Infections - drug therapy
Clostridium Infections - epidemiology
Community-Acquired Infections - drug therapy
Community-Acquired Infections - epidemiology
Diarrhea - epidemiology
Diarrhea - microbiology
Diarrhoea
Female
Gastroenterology and Hepatology
Hospitalization
Humans
Incidence
Infant
Infectious disease
Male
Retrospective Studies
Risk Factors
title Community-acquired Clostridium difficile infection in children: A retrospective study
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