Does saline enema during the first stage of labour reduce the incidence of  Clostridium difficile  colonization in neonates? A randomized controlled trial

Nada, A. A.; Mohsen, Reham A.; Hassan, Yosra M.; Sabry, Ayman; Soliman, Noha S.

doi:10.1016/j.jhin.2018.02.008

Cited by 5 publications

(8 citation statements)

References 18 publications

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“…Of the 95 eligible studies, 69 were cross-sectional studies (73%), 18 included prospective longitudinal data (19%), 1 (1%) included longitudinal and cross-sectional data, 3 (3%) were retrospective cohort studies, and 4 (4%) were clinical trials (eTable 2 in the Supplement). Study cohorts represented community (n = 42), hospital (n = 31), and neonatal intensive care unit (n = 6) populations.…”

Section: Resultsmentioning

confidence: 99%

“…Age groups included neonates (n = 13); infants (n = 24); and children 2 years or younger (n = 12), 3 years or younger (n = 3), 5 years or younger (n = 2), 8 years or younger (n = 2), 10 years or younger (n = 1), and older than 10 years (n = 32) . Seventy-seven studies included healthy children; other populations were premature or low-birth-weight infants (n = 6), patients with oncologic or hematologic disease (n = 9), patients with a diagnosis of malnourishment (n = 1), and outpatients attending gastroenterology clinics without C difficile –associated clinical symptoms (n = 2) (eTable 2 in the Supplement).…”

Section: Resultsmentioning

confidence: 99%

“…Fifty-three studies (55%) had no unclear items or items at risk of bias and thus were considered low risk-of-bias studies . Fifteen studies had a high risk of bias because the samples were not representative of the target population (eg, special populations) (eTable 3 in the Supplement).…”

Section: Resultsmentioning

confidence: 99%

“…Fifteen studies had a high risk of bias because the samples were not representative of the target population (eg, special populations) (eTable 3 in the Supplement). Most studies had either low (n = 88) or unclear (n = 5) risk of bias with regard to participant recruitment.…”

Section: Resultsmentioning

confidence: 99%

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Prevalence of Detection of Clostridioides difficile Among Asymptomatic Children

et al. 2021

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IMPORTANCE Detection of Clostridioides difficile has frequently been described in asymptomatic infants and children, but accurate estimates across the age spectrum are unavailable. OBJECTIVE To assess the prevalence of C difficile detection among asymptomatic children across the age spectrum. DATA SOURCES This systematic review and meta-analysis included a search of the Cochrane Central Register of Controlled Trials, MEDLINE, Embase, CINAHL, Scopus, and Web of Science for articles published from January 1, 1990, to December 31, 2020. Search terms included Clostridium difficile, Peptoclostridium difficile, Clostridioides difficile, CDF OR CDI OR c diff OR c difficile, Clostridium infections OR cd positive diarrhea OR cd positive diarrhea OR Clostridium difficile OR Peptoclostridium difficile OR pseudomembranous colitis OR pseudomembranous enterocolitis, enterocolitis, and pseudomembranous. These were combined with the following terms: bacterial colonization and colonization OR colonized OR colonizing OR epidemiology OR prevalence OR seroprevalence. STUDY SELECTION Studies were screened independently by 2 authors. Studies were included if they reported testing for C difficile among asymptomatic children (ie, children without diarrhea) younger than 18 years.DATA EXTRACTION AND SYNTHESIS Data were extracted independently and in duplicate by 2 reviewers. Preferred Reporting Items for a Systematic Review and Meta-analysis (PRISMA) guidelines were used. Data were pooled using a random-effects model. MAIN OUTCOMES AND MEASURESThe primary outcome was prevalence of C difficile detection among asymptomatic children. Secondary outcomes included prevalence of toxigenic vs nontoxigenic strains of C difficile and prevalence of C difficile detection stratified by geographic region, income status, testing method, and year of testing. RESULTS A total of 95 studies with 19 186 participants were included. Rates of detection of toxigenic or nontoxigenic C difficile were greatest among infants aged 6 to 12 months (41%; 95% CI, 32%-50%) and decreased to 12% (95% CI, 7%-18%) among children aged 5 to 18 years. The prevalence of toxigenic C difficile colonization was lower, peaking at 14% (95% CI, 8%-21%) among infants aged 6 to 12 months and decreasing to 6% (95% CI, 2%-11%) among children older than 5 years. Although prevalence differed by geographic region (ie, North and South America vs Europe: β, −0.151, P = .001; North and South America vs Western Pacific: β, 0.136, P = .007), there was no difference by testing method (ie, culture vs polymerase chain reaction: β, 0.069, P = .052; culture vs enzyme immunoassay: β, −0.178, P = .051), income class (low-middle income vs high income: β, −0.144, P = .23; upper-middle vs high income: β, −0.020,

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

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Prevalence of Detection of Clostridioides difficile Among Asymptomatic Children

et al. 2021

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“…14 After we earlier in 2020 reported the integrity problems with the 15 45 RCTs to editors and publishers who had published them, this has until now lead to retraction of 4 RCTs, with only a few editors and publishers notifying us that they are working on the problem. [15][16][17][18] Cochrane has decided not to use one other study for meta-analysis, pending clarification about the integrity of the study data, while the other 40 continue to 'inform' clinical practice. 19 20 Similar patterns are seen in other areas of medicine.…”

Section: Main Textmentioning

confidence: 99%