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

Borali, Elena; Ortisi, G; Moretti, Chiara; Stacul, Elisabetta; Lipreri, Rita; Gesu, Giovanni; Giacomo, Costantino De

doi:10.1016/j.dld.2015.06.002

Cited by 30 publications

(31 citation statements)

References 41 publications

(52 reference statements)

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…The Public Health Laboratory 2 https://www.bd.com/resource.aspx?IDX¼17953. 3 http://www.cepheid.com/us/cepheid-solutions/clinical-ivd-tests/healthcareassociated-infections/xpert-c-difficile. 4 http://www.hain-lifescience.de/en/products/microbiology/genotype-cdiff/ genotype-cdiff.html.…”

Section: Difficile Typing Methodsmentioning

confidence: 99%

“…These systems include BD GeneOhm™ Cdiff (Becton Dickenson) 2 and Xpert ® C. difficile (Cepheid). 3 These commercial RTPCRs have been shown to be rapid (<4 h for a result), sensitive and specific. Therefore, they have been largely proposed for the laboratory diagnosis of CDI [170e172].…”

Section: Laboratory Diagnosis Of CDImentioning

confidence: 99%

“…It is responsible for outbreaks of hospitalacquired infection, with symptoms including serious diarrhoea and, in several cases, pseudomembranous colitis and even death. Although the principal risk factors in patients are a history of antibiotic treatment, an age of over 65 years, and prolonged hospitalisation [1,2], in recent years, studies have described the bacterium spreading further into the community [3] and an increase in the incidence and severity of nosocomial C. difficile infection (CDI) in North America and Europe [4]. This rise has been attributed to the emergence of new hypervirulent strains, including PCRribotype 027 [5] and PCR-ribotype 078 [6], which has been associated with antimicrobial exposure.…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Clostridium difficile infection: Early history, diagnosis and molecular strain typing methods

Rodríguez

Broeck

Taminiau

et al. 2016

Microbial Pathogenesis

View full text Add to dashboard Cite

a b s t r a c tRecognised as the leading cause of nosocomial antibiotic-associated diarrhoea, the incidence of Clostridium difficile infection (CDI) remains high despite efforts to improve prevention and reduce the spread of the bacterium in healthcare settings. In the last decade, many studies have focused on the epidemiology and rapid diagnosis of CDI. In addition, different typing methods have been developed for epidemiological studies. This review explores the history of C. difficile and the current scope of the infection. The variety of available laboratory tests for CDI diagnosis and strain typing methods are also examined.

show abstract

Section: Difficile Typing Methodsmentioning

confidence: 99%

Section: Laboratory Diagnosis Of CDImentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Clostridium difficile infection: Early history, diagnosis and molecular strain typing methods

Rodríguez

Broeck

Taminiau

et al. 2016

Microbial Pathogenesis

View full text Add to dashboard Cite

show abstract

“…Of interest, both hospital (HA) -and community (CA) -associated CDI are increasing [9], but while in HA-CDI the above mentioned risk factors are usually found, these factors are often lacking in CA-CDI [10], where the main determinant factor is the presence of comorbidities and among these of inflammatory bowel disease (IBD) [6][7][8][9].…”

Section: Exploding or Rare Disease?mentioning

confidence: 99%

Clostridium Difficile in Children- A Multifaceted Infection

Giacomo¹,

Borali²

2016

Pediatric Infect Dis

Self Cite

View full text Add to dashboard Cite

Two case reports of children with muco-hemorrhagic diarrhea positive for Clostridium difficile introduce into the world of Clostridium difficile infection in the pediatric age. Epidemiological, clinical, and microbiological findings represent pieces of the puzzle of one of the most emerging infections at all the ages. Keywords: CommentaryTwo children were referred to our Pediatric Gastroenterology Unit for muco-hemorrhagic diarrhea. Patient 1:The first one was a 13-month-old boy, with a medical history started since the third trimester of pregnancy when a moderate bilateral dilation of urinary tract was demonstrated at ultrasonography. After a normal delivery he underwent to recurrent episodes of urinary tract infections caused by E.coli and treated with amoxicillin when, at age of 6 months, a urinary cistography showed a 3rd degree bilateral vesicouretheral reflux. At 9 months of age, he developed fever, vomiting and diarrhoea, and he was treated with IV cephalosporin for pyelonephritis. Successively, a prophylactic therapy with amoxicillin was started. Two months later, when he was 1-year-old, he developed progressively irritability, feeding refusal, associated with failure to thrive; an urine analysis showed the presence of an infection by E.coli resistant to amoxicillin and iv cephalosporin therapy was administrated at home. After a few days of clinical improvement, the reappearance of symptoms suggested to refer the child to a Hospital, where gentamicin was added to treatment. Five days later, a picture of mild diarrhoea appeared, and stools analysis for common viral and bacterial pathogens, revealed the presence of Rotavirus infection. Three days later, diarrhoea increased with progressive appearance of mucous and blood, fever and worsening of general conditions. For this reason the child was referred to our Hospital, where he arrived febrile (39 degrees Celsius of temperature), with mild dehydration , dilated abdomen, 5 to 7 muco-hemorrhagic evacuations daily, and laboratory evidence of leukocytosis (16000/mmc), and raised serum CRP (9.1 mg/L; n.v. <0.5 mg/L) . Urine, blood and faecal cultures were negative, but a search for toxigenic Clostridium difficile (CD) came back positive suggesting a presumptive diagnosis of Clostridium difficile infection (CDI). Discontinuation of cephalosporin and gentamicin and prompt administration of oral metronidazole (25-30 mg/kg/day qid x 10 days) induced an amelioration of clinical picture within 36 hours with complete remission after 3 days of such a treatment. Patient 2:The second patient was a 14-year-old girl, without any significant clinical history, who developed a severe diarrhoea with more than 8 loose stools for day with mucous and blood, fever and abdominal pain. Laboratory analysis showed anaemia (8.3 g/dl), thrombocytosis (580000/mmc), raised ESR (75 mm/hr) and CRP (7 mg/L; n.v. <0.5 mg/L), and the presence of toxigenic C. difficile in the stools. A treatment with metronidazole alone first and combined with IV later, didn't improve the clinical pictu...

show abstract

“…Despite the increasing attention it has received, the worldwide rates of CDI have continued to steadily increase noticeably since 2000, especially among recently hospitalized elderly patients or among long-term care facility residents (6). The epidemiology of C. difficile has changed more seriously in the past decade.…”

Section: Introductionmentioning

confidence: 99%

Epidemiology of Clostridium difficile in a County Level Hospital in China

Yan¹,

Liang²,

Lv³

et al. 2017

Jundishapur J Microbiol

View full text Add to dashboard Cite

Background: The incidence of Clostridium difficile infection (CDI) has markedly increased over the past decade. Although its epidemiology has been previously investigated in tertiary hospitals, no studies have investigated the prevalence of CDI in county level hospitals in China. Objectives: This study aimed at describing the molecular characteristics of toxigenic C. difficile isolated from a community level hospital and evaluating physicians' knowledge on CDI. Methods: We conducted a 15-month study at a country level hospital to characterize clinical isolates of C. difficile. A total of 61 toxigenic strains were isolated including 54 strains (88.5%), with both tcdA and tcdB genes positive and the remaining positive for the tcdB gene alone. Results: No binary toxin was detected. The toxigenic strains were found to be susceptible to vancomycin and metronidazole and exhibited high levels of resistance to clindamycin, levofloxacin, erythromycin, and ciprofloxacin. The most toxigenic C. difficile isolate was obtained from the gastroenterology and infection ward. Additionally, 13 sequence types (STs) were identified; ST-54 (32.8%), , , and ST-37 (11.5%) were the most common types. Conclusions:The results of the present study indicate that CDI may be a common problem, and large-scale multicenter studies are required to reveal the actual extent of the burden of CDI in county level hospitals.

show abstract

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

Cited by 30 publications

References 41 publications

Clostridium difficile infection: Early history, diagnosis and molecular strain typing methods

Clostridium difficile infection: Early history, diagnosis and molecular strain typing methods

Clostridium Difficile in Children- A Multifaceted Infection

Epidemiology of Clostridium difficile in a County Level Hospital in China

Contact Info

Product

Resources

About