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Clostridium difficile in childrens

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https://www.readbyqxmd.com/read/28882583/clinical-and-epidemiological-characteristics-in-hospitalized-young-children-with-acute-gastroenteritis-in-southern-taiwan-according-to-major-pathogens
#1
Ning Chung, Shih-Min Wang, Ching-Fen Shen, Fu-Chun Kuo, Tzong-Shiann Ho, Chao Agnes Hsiung, Jung-Jung Mu, Fang-Tzy Wu, Li-Min Huang, Yi-Chuan Huang, Yhu-Chering Huang, Hsin Chi, Hsiao-Chuan Lin, Ching-Chuan Liu
BACKGROUND: Acute gastroenteritis (AGE) can be caused by a wide array of pathogens, including bacteria, viruses, and parasites. A prospective study to investigate the epidemiology and clinical presentation in young children hospitalized with AGE was conducted in a medical center in southern Taiwan. METHODS: Patients aged less than 5 years who was hospitalized due to AGE in National Cheng Kung University Hospital were enrolled from July 2014 to June 2016. The demographic information, clinical features and laboratory data were collected by chart reviews, and stool samples were sent to Centers of Disease Control, Taiwan (Taiwan CDC) for a panel of pathogen identification consisting of two viruses, nine bacteria, and five parasites...
August 31, 2017: Journal of Microbiology, Immunology, and Infection, Wei Mian Yu Gan Ran za Zhi
https://www.readbyqxmd.com/read/28827186/probiotics-and-antibiotic-associated-diarrhea-in-children-a-review-and-new-evidence-on-lactobacillus-rhamnosus-gg-during-and-after-antibiotic-treatment
#2
REVIEW
Cecilia Mantegazza, Paola Molinari, Enza D'Auria, Micol Sonnino, Lorenzo Morelli
Antibiotic associated diarrhea (AAD) is a common complication in childhood in the outpatient and inpatient settings. This review provides up to date information on the use of probiotics in the prevention and treatment of AAD, including that from Clostridium Difficile, in children. The most recently systematic reviews and subsequently published randomized controlleds trials are considered. Different single and multistrain probiotics are described; a specific recommendation for the use of Lactobacillus Rhamnosus GG (LGG) and Saccharomyces boulardii (Sb) emerges...
August 18, 2017: Pharmacological Research: the Official Journal of the Italian Pharmacological Society
https://www.readbyqxmd.com/read/28816966/causes-of-hematochezia-and-hemorrhagic-antibiotic-associated-colitis-in-children-and-adolescents
#3
Laura Stampfer, Andrea Deutschmann, Elisabeth Dür, Franz G Eitelberger, Theresia Fürpass, Gregor Gorkiewicz, Peter Heinz-Erian, Ingrid Heller, Kathrin Herzog, Barbara Hopfer, Reinhold Kerbl, Evelyn Klug, Robert Krause, Eva Leitner, Christoph Mache, Thomas Müller, Jasmin Pansy, Mirjam Pocivalnik, Eva Scheuba, Georg Schneditz, Gerolf Schweintzger, Edith Sterniczky, Ellen Zechner, Almuthe C Hauer, Christoph Högenauer, Karl Martin Hoffmann
Diseases causing hematochezia range from benign to potentially life-threatening. Systematic pediatric data on the causes of hematochezia are scarce. We studied the underlying causes and long-term outcome of hematochezia in children. We further investigated the relevance of antibiotic-associated hemorrhagic colitis in children, especially if caused by Klebsiella oxytoca.Infants, children, and adolescents with hematochezia were recruited prospectively. Patients were grouped according to age (<1 year, 1-5 years, 6-13 years, >14 years)...
August 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28813461/epidemiology-of-clostridium-difficile-in-infants-in-oxfordshire-uk-risk-factors-for-colonization-and-carriage-and-genetic-overlap-with-regional-c-difficile-infection-strains
#4
Nicole Stoesser, David W Eyre, T Phuong Quan, Heather Godwin, Gemma Pill, Emily Mbuvi, Alison Vaughan, David Griffiths, Jessica Martin, Warren Fawley, Kate E Dingle, Sarah Oakley, Kazimierz Wanelik, John M Finney, Melina Kachrimanidou, Catrin E Moore, Sherwood Gorbach, Thomas V Riley, Derrick W Crook, Tim E A Peto, Mark H Wilcox, A Sarah Walker
BACKGROUND: Approximately 30-40% of children <1 year of age are Clostridium difficile colonized, and may represent a reservoir for adult C. difficile infections (CDI). Risk factors for colonization with toxigenic versus non-toxigenic C. difficile strains and longitudinal acquisition dynamics in infants remain incompletely characterized. METHODS: Predominantly healthy infants (≤2 years) were recruited in Oxfordshire, UK, and provided ≥1 fecal samples. Independent risk factors for toxigenic/non-toxigenic C...
2017: PloS One
https://www.readbyqxmd.com/read/28791215/clostridium-difficile-infections-in-young-infants-case-presentations-and-literature-review
#5
Gé-Ann Kuiper, Joffrey van Prehn, Wim Ang, Frank Kneepkens, Sophie van der Schoor, Tim de Meij
It has been assumed that symptomatic Clostridium difficile infections do not occur in young infants, as this specific group would lack specific C. difficile toxin receptors. As a consequence, it is often current practice not to test for C. difficile in neonates and young infants up to 2 years of age presenting with (bloody) diarrhea. The evidence to support this is, however, weak and largely based on small, poorly designed animal studies. We present two young infants with recurrent bloody diarrhea following antimicrobial therapy, positive testing for toxigenic C...
2017: IDCases
https://www.readbyqxmd.com/read/28790133/detection-of-acute-gastroenteritis-etiology-in-hospitalized-young-children-associated-factors-and-outcomes
#6
Jamie M Pinto, Anna Petrova
BACKGROUND: The decision to test for the etiology of diarrhea is a challenging question for practicing pediatricians. METHODS: The main goal of this retrospective cohort study was to identify factors associated with testing for and diagnosis of rotavirus, Clostridium difficile, or other bacterial infections, as well as the length of stay (LOS) for children with acute gastroenteritis who were hospitalized at a single institution. Patients aged 6 to 60 months with acute diarrhea (<14 days) and no underlying gastrointestinal conditions were included...
September 2017: Hospital Pediatrics
https://www.readbyqxmd.com/read/28762696/probiotics-for-gastrointestinal-conditions-a-summary-of-the-evidence
#7
REVIEW
Thad Wilkins, Jacqueline Sequoia
Probiotics contain microorganisms, most of which are bacteria similar to the beneficial bacteria that occur naturally in the human gut. Probiotics have been widely studied in a variety of gastrointestinal diseases. The most-studied species include Lactobacillus, Bifidobacterium, and Saccharomyces. However, a lack of clear guidelines on when to use probiotics and the most effective probiotic for different gastrointestinal conditions may be confusing for family physicians and their patients. Probiotics have an important role in the maintenance of immunologic equilibrium in the gastrointestinal tract through the direct interaction with immune cells...
August 1, 2017: American Family Physician
https://www.readbyqxmd.com/read/28730135/clinical-characteristics-and-ultrasonographic-findings-of-acute-bacterial-enterocolitis-in-children
#8
Peter Chun, Taek Jin Lim, Eun Ha Hwang, Sang Wook Mun, Yeoun Joo Lee, Jae Hong Park
PURPOSE: This study clarified the bacterial pathogens currently causing acute infectious enterocolitis (AIE) in children and evaluated the clinical characteristics and ultrasonographic findings according to the different pathogens. METHODS: Medical records regarding age, sex, clinical symptoms, laboratory data, identified enteropathogens, ultrasonographic findings, treatment, and outcome of 34 patients who were diagnosed with AIE via stool examination using multiplex polymerase chain reaction (PCR) or culture, were retrospectively reviewed...
June 2017: Pediatric Gastroenterology, Hepatology & Nutrition
https://www.readbyqxmd.com/read/28707191/clostridium-difficile-colitis-and-colonoscopy-pediatric-perspective
#9
REVIEW
Randolph McConnie, Arthur Kastl
PURPOSE OF THE REVIEW: Review tests available for detection of Clostridium difficile (C. Diff) induced disease, including when such tests should be done in children and how they should be interpreted. RECENT FINDINGS: Multiple tests are available for detecting disease due to C. diff. These include colonoscopy and stool analysis. Colonoscopy with biopsy is the most sensitive test for detecting the presence of colitis. The toxins produced by the C. diff. (toxin A, toxin B, and binary toxin) are the agents that cause injury and disease...
August 2017: Current Gastroenterology Reports
https://www.readbyqxmd.com/read/28689671/detection-of-toxigenic-clostridium-difficile-in-paediatric-patients
#10
Iker Falces-Romero, Paloma Troyano-Hernáez, Silvia García-Bujalance, Fernando Baquero-Artigao, María José Mellado-Peña, Julio García-Rodríguez
INTRODUCTION: Our main objective was a revision of clinical, microbiological and epidemiological results of Clostridium difficile-associated infection in paediatric patients (2010-2015). We compared the diagnoses performed by detection of toxins in feces and those performed by real-time PCR. METHODS: This retrospective study included 82 paediatric patients. Detection of toxigenic C. difficile was performed sequentially, in diarrheal feces and under clinical request...
July 6, 2017: Enfermedades Infecciosas y Microbiología Clínica
https://www.readbyqxmd.com/read/28686001/recreational-sandboxes-for-children-and-dogs-can-be-a-source-of-epidemic-ribotypes-of-clostridium-difficile
#11
Cristina Orden, Carlos Neila, José L Blanco, Sergio Álvarez-Pérez, Celine Harmanus, Ed J Kuijper, Marta E García
Different studies have suggested that the sand of public playgrounds could have a role in the transmission of infections, particularly in children. Furthermore, free access of pets and other animals to the playgrounds might increase such a risk. We studied the presence of Clostridium difficile in 20 pairs of sandboxes for children and dogs located in different playgrounds within the Madrid region (Spain). Clostridium difficile isolation was performed by enrichment and selective culture procedures. The genetic (ribotype and amplified fragment length polymorphism [AFLP]) diversity and antibiotic susceptibility of isolates was also studied...
July 7, 2017: Zoonoses and Public Health
https://www.readbyqxmd.com/read/28646951/fecal-microbiota-transplantation-for-recurrent-clostridium-difficile-infection-in-children
#12
Becky Chen, Vishal Avinashi, Simon Dobson
Fecal microbiota transplantation (FMT) is a relatively simple, promising treatment for recurrent Clostridium difficile infection. While there are a wide variety of approaches including mode of delivery, the results are nonetheless encouraging, even amongst younger children. Experience with FMT in the pediatric population is increasing, showing similar success compared to adults. This article will provide an overview of C. difficile infection along with review of the rationale, methods and complications of FMT including the current experience of FMT in children...
June 2017: Journal of Infection
https://www.readbyqxmd.com/read/28575523/safety-and-pharmacokinetic-study-of-fidaxomicin-in-children-with-clostridium-difficile-associated-diarrhea-a-phase-2a-multicenter-clinical-trial
#13
Molly A O'Gorman, Marian G Michaels, Sheldon L Kaplan, Anthony Otley, Larry K Kociolek, Edward J Hoffenberg, Kwang Sik Kim, Sharon Nachman, Marian D Pfefferkorn, Timothy Sentongo, Janice E Sullivan, Pamela Sears
Background.: Fidaxomicin is an approved therapy for Clostridium difficile-associated diarrhea (CDAD) in adults. The safety of fidaxomicin in children has not been reported. Methods.: In this study (ClinicalTrials.gov identifier NCT01591863), pediatric patients with CDAD received twice-daily oral fidaxomicin at a dose of 16 mg/kg per day (up to 200 mg) for 10 days in an open-label study. Plasma and fecal samples were collected for pharmacokinetic assessments. The primary outcome measure was safety, which was assessed by adverse-event (AE), laboratory, and physical examination/vital-sign monitoring...
May 31, 2017: Journal of the Pediatric Infectious Diseases Society
https://www.readbyqxmd.com/read/28441827/-colonization-rate-of-clostridium-difficile-in-healthy-children
#14
Y Wang, S Guo, C N Zhao, X W Xu
Objective: To learn the colonization of Clostridium difficile in local healthy children and to investigate the colonization rate and toxin types of Clostridium difficile at different ages. Method: From September 2014 to January 2015 in a case observational study, healthy children's fecal specimens from the health care department of Beijing Children's Hospital were collected. The children were divided into four groups according to age: <1 year old(n=53), 1-<3 years old(n=50), 3-<6 years old(n=50) and 6-<14 years old(n=50) respectively...
April 2, 2017: Zhonghua Er Ke za Zhi. Chinese Journal of Pediatrics
https://www.readbyqxmd.com/read/28420276/the-influence-of-maternal-vaginal-flora-on-the-intestinal-colonization-in-newborns-and-3-month-old-infants
#15
Iwona Gabriel, Anita Olejek, Krystyna Stencel-Gabriel, Miroslaw Wielgoś
AIM: The role of maternal vaginal bacteria on the colonization of neonatal gut is still a matter of discussion. Our aim was to estimate the role of maternal vaginal flora on the development of intestinal flora in neonates and 3-month-old infants. METHODS: Seventy-nine maternal-neonatal pairs were included in the study. Vaginal swabs were taken before the rupture of membranes after admission to the delivery ward. First neonatal stool (meconium) and stool at 3-month-old infants were collected and cultured...
May 9, 2017: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/28396027/risk-factors-for-community-associated-clostridium-difficile-infection-in-children
#16
Daniel J Adams, Matthew D Eberly, Michael Rajnik, Cade M Nylund
OBJECTIVE: To characterize the medication and other exposures associated with pediatric community-associated Clostridium difficile infections (CA-CDIs). STUDY DESIGN: We performed a case-control study using billing records from the US military health system database. CA-CDI cases included children 1-18 years of age with an outpatient International Classification of Diseases, Ninth Revision, Clinical Modification diagnostic code for Clostridium difficile infection (CDI) from 2001 to 2013...
July 2017: Journal of Pediatrics
https://www.readbyqxmd.com/read/28371243/infection-rates-in-tacrolimus-versus-cyclosporine-treated-pediatric-kidney-transplant-recipients-on-a-rapid-discontinuation-of-prednisone-protocol-1-year-analysis
#17
Sarah J Kizilbash, Michelle N Rheault, Ananta Bangdiwala, Arthur Matas, Srinath Chinnakotla, Blanche M Chavers
AR is lower in pKTx recipients on Tac vs CsA. Data comparing infection outcomes for children treated with these agents are limited. We retrospectively studied infection outcomes in 96 pKTx recipients on a RDP. PS, DCGS, AR, and infection-free survival were assessed using Kaplan-Meier/log-rank tests and proportional hazards models. There were no differences in 1-year PS, DCGS, or AR between Tac and CsA recipients. After adjusting for AR, the hazard of CMV viremia was 4.0 times higher (95%CI: 1.04, 15.5; P = ...
June 2017: Pediatric Transplantation
https://www.readbyqxmd.com/read/28302431/a-qualitative-study-to-identify-reasons-for-clostridium-difficile-testing-in-pediatric-inpatients-receiving-laxatives-or-stool-softeners
#18
Joanne Kinlay, Thomas J Sandora
To understand why clinicians send Clostridium difficile tests from hospitalized children receiving laxatives or stool softeners, we performed a mixed-methods study. We prospectively identified tested patients and surveyed their clinicians by e-mail. Reasons for testing included changes in stooling pattern on baseline bowel regimen, other changes in clinical status, and risk factors for C difficile infection. Education targeting discontinuing bowel medications before C difficile testing could improve the specificity of pediatric C difficile infection diagnosis...
May 1, 2017: American Journal of Infection Control
https://www.readbyqxmd.com/read/28257541/risk-factors-for-outpatient-use-of-antibiotics-in-children-with-acute-respiratory-illnesses
#19
Sophie R Zhao, Marie R Griffin, Barron L Patterson, Rachel L Mace, Dayna Wyatt, Yuwei Zhu, H Keipp Talbot
OBJECTIVES: Antibiotics for acute respiratory illness (ARI) constitute most pediatric medication use and contribute to the emergence of antimicrobial resistance. We investigated antibiotic prescription risk factors for ARI in pediatric clinics and clinical follow-up in individuals prescribed and not prescribed antibiotics. METHODS: In this observational study, we enrolled children ages 2 to 17 years old presenting with ARI with fever to two academic pediatric primary care outpatient clinics during influenza season 2013-2014...
March 2017: Southern Medical Journal
https://www.readbyqxmd.com/read/28219462/the-use-of-a-computerized-provider-order-entry-alert-to-decrease-rates-of-clostridium-difficile-testing-in-young-pediatric-patients
#20
Maribeth R Nicholson, Peter N Freswick, M Cecilia Di Pentima, Li Wang, Kathryn M Edwards, Gregory J Wilson, Thomas R Talbot
BACKGROUND Infants and young children are frequently colonized with C. difficile but rarely have symptomatic disease. However, C. difficile testing remains prevalent in this age group. OBJECTIVE To design a computerized provider order entry (CPOE) alert to decrease testing for C. difficile in young children and infants. DESIGN An interventional age-targeted before-after trial with comparison group SETTING Monroe Carell Jr. Children's Hospital at Vanderbilt University, Nashville, Tennessee. PATIENTS All children seen in the inpatient or emergency room settings from July 2012 through July 2013 (pre-CPOE alert) and September 2013 through September 2014 (post-CPOE alert) INTERVENTION In August of 2013, we implemented a CPOE alert advising against testing in infants and young children based on the American Academy of Pediatrics recommendations with an optional override...
May 2017: Infection Control and Hospital Epidemiology
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