Clostridium difficile infection in children hospitalized due to diarrhea

• Published in: European journal of clinical microbiology & infectious diseases 2014-02, Vol.33 (2), p.201-209
• Main Authors: Dulba, K, Pawowska, M, Wietlicka-piszcz, M
• Format: Article
• Language: English
• Subjects: Adolescent; Age groups; Antibiotics; Bacteria; Bacterial diseases; Bacterial diseases of the digestive system and abdomen; Bacterial Toxins - genetics; Biological and medical sciences; Biomedical and Life Sciences; Biomedicine; Child; Child, Preschool; Chronic illnesses; Clostridium difficile - genetics; Clostridium difficile - isolation & purification; Clostridium Infections - epidemiology; Clostridium Infections - microbiology; Clostridium Infections - mortality; Clostridium Infections - pathology; Community-Acquired Infections - epidemiology; Community-Acquired Infections - microbiology; Community-Acquired Infections - mortality; Community-Acquired Infections - pathology; Cross Infection - epidemiology; Cross Infection - microbiology; Cross Infection - mortality; Cross Infection - pathology; Diarrhea; Diarrhea - epidemiology; Diarrhea - microbiology; Diarrhea - mortality; Diarrhea - pathology; Epidemics; Epidemiology; Gastroenterology. Liver. Pancreas. Abdomen; Hospitalization; Human bacterial diseases; Humans; Infant; Infectious diseases; Internal Medicine; Male; Medical Microbiology; Medical sciences; Morbidity; Nosocomial infections; Other diseases. Semiology; Pediatrics; Polymerase Chain Reaction; Prevalence; Recurrence; Retrospective Studies; Risk Factors; Severity of Illness Index; Stomach. Duodenum. Small intestine. Colon. Rectum. Anus; Toxicity; Toxins
• ISSN: 0934-9723; 1435-4373
• DOI: 10.1007/s10096-013-1946-1

The frequency of Clostridium difficile infection (CDI)-related hospitalizations is increasing. The aim of this study was to determine the extent of CDI among children hospitalized with diarrhea, risk factors or predictors for severe CDI, the prevalence of NAP1, and to compare the course of CDI depending on bacteria toxicity profile. A retrospective analysis of case records of 64 children (age range 3 months–16 years, median age 2.12 years) with CDI as defined by diarrheal disease and positive polymerase chain reaction (PCR) test (Xpert C. difficile ) was conducted. Modified national adult guidelines were used to assess the severity of CDI. CDIs represented 2.7 % of patients with diarrhea (13.5 cases per 1,000 admissions). Thirty-three CDIs (52 %) were community-associated. Antibacterial use preceded CDI in 61 patients (95 %). Seventeen cases (27 %) were binary toxin-positive (CDT+), 13 of which were NAP1 (20.5 %). Over 75 % of CDIs with NAP1 was hospital-acquired, and more often proceeded with generalized infection ( p