Epidemiological investigation of Clostridioides difficile colonization in Chinese community infants

Cui, Qing-qing; Yang, Jing; Niu, Yanan; Qiang, Cuixin; Li, Zhirong; Xu, Kaiyue; Li, Ruxin; Shi, Dongquan; Wei, Haiming; Zhao, Xinghui; Wang, Xiaoming; Sun, Suzhen; Zhao, Jianhong

doi:10.1016/j.anaerobe.2019.01.008

Cited by 12 publications

(18 citation statements)

References 49 publications

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“…In a French study [25], all isolates were metronidazole, vancomycin and linezolid susceptible and moxifloxacin resistance was low (3-10%). In a Chinese study on community infants aged 36 months, toxigenic isolates were more often ceftriaxone resistant compared with nontoxigenic isolates and the nontoxigenic isolates were more frequently rifaximin and rifampicin resistant compared with the toxigenic isolates [30]. In our study, the four C. difficile isolates were levofloxacin and moxifloxacin resistant and vancomycin and metronidazole susceptible except for one strain showing single metronidazole resistant colonies as a subpopulation within the inhibitory zone of the E test strip.…”

Section: Antibiotic Susceptibility Of C Difficile Isolatescontrasting

confidence: 43%

“…There are variations in the colonization rates with nontoxigenic and toxigenic C. difficile. However, although in French infants aged 0-3 years, the C. difficile colonization rate (45%) was higher than that (22.8%) in Chinese infants of the same age, the carriage of toxigenic isolates was about 13% in both studies [26,30].…”

Section: Age-dependent Prevalencementioning

confidence: 68%

“…It is alarming that since 2000, there has been emergence and subsequent increase in infections caused by hypervirulent strains such as PCR ribotypes 027 and 078 [10,24]. In asymptomatic children, however, carriage of hypervirulent C. difficile has been usually low (0.1%) or absent according to studies from China, France, Japan and the United Kingdom [25][26][27][28][29][30][31]. Similarly, no binary toxin positive C. difficile colonization was found among the 61 asymptomatic Bulgarian children in our study.…”

Section: Resultsmentioning

confidence: 99%

“…High asymptomatic colonization rates have been found in studies in France, detecting C. difficile in >33% of children aged <3 years [25,26]. In a recent Chinese study on community infants aged 36 months, the rate of C. difficile colonization was 22.8%, and, importantly, >55% of the strains were toxin-producers [30]. Children aged 25-36 months were the most frequent carriers of C. difficile (52.4%) and toxigenic isolates (23.8%) [30].…”

Section: Age-dependent Prevalencementioning

confidence: 96%

“…In a recent Chinese study on community infants aged 36 months, the rate of C. difficile colonization was 22.8%, and, importantly, >55% of the strains were toxin-producers [30]. Children aged 25-36 months were the most frequent carriers of C. difficile (52.4%) and toxigenic isolates (23.8%) [30]. However, in another Chinese study, toxigenic C. difficile was PCR detected in all age groups: in children aged <1 year (7.5%), in those aged 1 to <3 years (8.0%), as well as in the age group of 3 to <6 years (2.0%) and in that of 6 to <14 years (12.0%) [28].…”

Section: Age-dependent Prevalencementioning

confidence: 99%

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Clostridioides (Clostridium) difficile carriage in asymptomatic children since 2010: a narrative review

Boyanova

Kalvatchev

Yordanov

et al. 2019

Biotechnology & Biotechnological Equipment

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Section: Antibiotic Susceptibility Of C Difficile Isolatescontrasting

confidence: 43%

Section: Age-dependent Prevalencementioning

confidence: 68%

Section: Resultsmentioning

confidence: 99%

Section: Age-dependent Prevalencementioning

confidence: 96%

Section: Age-dependent Prevalencementioning

confidence: 99%

See 3 more Smart Citations

Clostridioides (Clostridium) difficile carriage in asymptomatic children since 2010: a narrative review

Boyanova

Kalvatchev

Yordanov

et al. 2019

Biotechnology & Biotechnological Equipment

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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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