Occurrence and significance of clostridium difficile in faecal specimens of hospitalized children

Clostridium difficile in Children: A Review of Existing and Recently Uncovered Evidence

“…Karsch et al [55] found high rates of carriage, particularly in infants (30 %), with most isolates producing toxin (82 % toxin A and 43 % toxin B), but no significant difference between symptomatic children and controls, and no clear association with previous antibiotic therapy. A prospective study in Denmark also showed significantly higher isolation of C. difficile in infants and no relationship to antibiotic exposure ( p < 0.001), but it was the only identified pathogen in 12 % of children of all ages with acute gastroenteritis, and this was significantly ( p <0.01) higher than for asymptomatic controls [21].…”

“…Despite the conflicting evidence for an association between antibiotic usage and CDI in children (against association: [11,20,21,45,55,74,75]; for association: [14,47,48,63,[76][77][78][79]), severe diarrhoea in the context of recent antibiotic therapy is likely to remain one such predictor that clinicians will use.…”

Clostridium difficile Colonization in Asymptomatic Infants 1 to 12 Months Old, Admitted to a Community Hospital

“…Previous studies have reported that the incidence of asymptomatic colonization in infants 1 to 12 months old varies from 6.6% to 70%. 1 -36 C difficile is detected by stool evaluation with selective anaerobic culture, enzyme immunoassay, PCR, or cell culture cytotoxin assay. When determined by toxin assay, the colonization rate of C difficile in infants ranges from 4.5% to 54%.…”

“…The presence of C difficile and its toxin has been identified in previously healthy infants without diarrhea, indicating asymptomatic colonization. 1 -36 Previous studies have shown rates of asymptomatic colonization in infants as low as 6.6% and as high as 70%. 1 -36 This is the first study in the state of Arizona that investigates the rate of...…”

Pediatric Clostridium difficile: A Phantom Menace or Clinical Reality?

“…Thus, this study challenges the long‐established concept that no pathogenicity from C. difficile exists in the neonatal population. Karsch et al (47) studied 766 children in hospitals and reported 17.3% of the children less than 12 months of age had C. difficile diarrhea. The frequency was found to decrease if the children were older (5.6% for ages 12–24 months and 2.7% for ages >24 months).…”