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Clostridium difficile in childrens

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https://www.readbyqxmd.com/read/28302431/a-qualitative-study-to-identify-reasons-for-clostridium-difficile-testing-in-pediatric-inpatients-receiving-laxatives-or-stool-softeners
#1
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...
March 13, 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
#2
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
#3
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...
February 21, 2017: Infection Control and Hospital Epidemiology
https://www.readbyqxmd.com/read/28182338/evaluation-of-nested-polymerase-chain-reaction-and-immunoassay-for-rapid-diagnosis-of-clostridium-difficile-in-children-with-community-acquired-diarrhea
#4
Ahmed Elewa, Maysaa El Sayed-Zaki
BACKGROUND: Clostridium difficile (C. difficile) is a known pathogen associated with diarrhea especially in hospital acquired diarrhea. Yet, it is being recognized as a probable etiology for community acquired diarrhea. The aim of the present study was to detect the presence of C. difficile as a pathogen causing community acquired diarrhea in children and to verify the value of different laboratory methods for diagnosis, namely specific culture, immunoassay for toxin detection, and nested polymerase chain reaction (nested-PCR)...
February 1, 2017: Clinical Laboratory
https://www.readbyqxmd.com/read/28173947/cost-analysis-of-nonoperative-management-of-acute-appendicitis-in-children
#5
Martina Mudri, Kamary Coriolano, Andreana Bütter
PURPOSE: The purpose of this study was to determine if nonoperative management of acute appendicitis in children is more cost effective than appendectomy. METHODS: A retrospective review of children (6-17years) with acute appendicitis treated nonoperatively (NOM) from May 2012 to May 2015 was compared to similar patients treated with laparoscopic appendectomy (OM) (IRB#107535). Inclusion criteria included symptoms ≤48h, localized peritonitis, and ultrasound confirmation of acute appendicitis...
January 30, 2017: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/28145650/epidemiology-and-factors-related-to-clinical-severity-of-acute-gastroenteritis-in-hospitalized-children-after-the-introduction-of-rotavirus-vaccination
#6
Ahlee Kim, Ju Young Chang, Sue Shin, Hana Yi, Jin Soo Moon, Jae Sung Ko, Sohee Oh
We aimed to investigate epidemiology and host- and pathogen-related factors associated with clinical severity of acute gastroenteritis (AGE) in children after rotavirus vaccination introduction. Factors assessed included age, co-infection with more than 2 viruses, and virus-toxigenic Clostridium difficile co-detection. Fecal samples and clinical information, including modified Vesikari scores, were collected from hospitalized children with AGE. The presence of enteric viruses and bacteria, including toxigenic C...
March 2017: Journal of Korean Medical Science
https://www.readbyqxmd.com/read/28104319/the-mexican-consensus-on-probiotics-in-gastroenterology
#7
M A Valdovinos, E Montijo, A T Abreu, S Heller, A González-Garay, D Bacarreza, M Bielsa-Fernández, M C Bojórquez-Ramos, F Bosques-Padilla, A I Burguete-García, R Carmona-Sánchez, A Consuelo-Sánchez, E Coss-Adame, J A Chávez-Barrera, M de Ariño, J Flores-Calderón, O Gómez-Escudero, M S González-Huezo, M E Icaza-Chávez, A Larrosa-Haro, M Morales-Arámbula, C Murata, J A Ramírez-Mayans, J M Remes-Troche, T Rizo-Robles, M Peláez-Luna, E M Toro-Monjaraz, A Torre, M E Urquidi-Rivera, R Vázquez, J K Yamamoto-Furusho, F Guarner
INTRODUCTION: Probiotics are frequently prescribed in clinical practice. Their efficacy in treating gastrointestinal disorders is supported by a significant number of clinical trials. However, the correct prescription of these agents is hampered due to a lack of knowledge of the scientific evidence and to the different presentations and microbial compositions of the probiotics that are currently available. AIM: To provide the clinician with a consensus review of probiotics and recommendations for their use in gastroenterology...
January 16, 2017: Revista de Gastroenterología de México
https://www.readbyqxmd.com/read/28057659/lactobacillus-reuteri-dsm-17938-in-the-prevention-of-antibiotic-associated-diarrhoea-in-children-protocol-of-a-randomised-controlled-trial
#8
Maciej Kołodziej, Hania Szajewska
INTRODUCTION: Administration of some probiotics appears to reduce the risk of antibiotic-associated diarrhoea (AAD). The effects of probiotics are strain-specific, thus, the efficacy and safety of each probiotic strain should be established separately. We aim to assess the effects of Lactobacillus reuteri DSM 17938 administration for the prevention of diarrhoea and AAD in children. METHODS AND ANALYSIS: A total of 250 children younger than 18 years treated with antibiotics will be enrolled in a double-blind, randomised, placebo-controlled trial in which they will additionally receive L...
January 5, 2017: BMJ Open
https://www.readbyqxmd.com/read/28042242/perceptions-of-fecal-microbiota-transplantation-for-clostridium-difficile-infection-factors-that-predict-acceptance
#9
Leslie Park, Anjali Mone, Jennifer C Price, Demetrios Tzimas, Jacqueline Hirsh, Michael A Poles, Lisa Malter, Lea Ann Chen
BACKGROUND: Despite the effectiveness of fecal microbiota transplantation (FMT) for treating recurrent Clostridium difficile (C. difficile) infection, some patients are reluctant to accept this therapy. Our study examined attitudes towards FMT and factors that contribute to patients' acceptance of this treatment. METHODS: We distributed patient surveys at a Veterans Affairs hospital, a public hospital, and an academic faculty practice. Multivariable logistic regression was performed, adjusting for factors associated with FMT acceptance on univariate analysis and prior experience with C...
2017: Annals of Gastroenterology: Quarterly Publication of the Hellenic Society of Gastroenterology
https://www.readbyqxmd.com/read/28028357/can-probiotics-benefit-children-with-autism-spectrum-disorders
#10
REVIEW
Fernando Navarro, Yuying Liu, Jon Marc Rhoads
Children with autism are commonly affected by gastrointestinal problems such as abdominal pain, constipation and diarrhea. In recent years, there has been a growing interest in the use of probiotics in this population, as it hypothetically may help to improve bowel habits and the behavioral and social functioning of these individuals. The gut microbiome plays an important role in the pathophysiology of organic as well as functional gastrointestinal disorders. Microbial modification with the use of antibiotics, probiotics, and fecal transplantation have been effective in the treatment of conditions such as recurrent Clostridium difficile infection, pouchitis, and irritable bowel syndrome...
December 14, 2016: World Journal of Gastroenterology: WJG
https://www.readbyqxmd.com/read/28024858/costs-of-clostridium-difficile-infection-in-pediatric-operations-a-propensity-score-matching-analysis
#11
Afif N Kulaylat, Dorothy V Rocourt, Abigail B Podany, Brett W Engbrecht, Marianne Twilley, Mary C Santos, Robert E Cilley, Christopher S Hollenbeak, Peter W Dillon
BACKGROUND: The purpose of this analysis was to assess the burden of Clostridium difficile infection in the hospitalized pediatric surgical population and to characterize its influence on the costs of care. METHODS: There were 313,664 patients age 1-18 years who underwent a general thoracic or abdominal procedure in the Kids' Inpatient Database during 2003, 2006, 2009, and 2012. Logistic regression was used to model factors associated with the development of C difficile infection...
December 23, 2016: Surgery
https://www.readbyqxmd.com/read/28008787/a-review-of-dose-responses-of-probiotics-in-human-studies
#12
A C Ouwehand
The probiotic definition requires the administration of an 'adequate amount' in order to obtain a health benefit. What that amount should be is not indicated. Here, an overview is given of studies that investigated the dose-response relation of probiotics in human interventions. Studies were divided in; meta-analyses, meta-analyses on specific probiotic strains, and studies testing two or more doses of a probiotic (combination) in the same study. Meta-analyses on the effect of probiotics on antibiotic associated diarrhoea (AAD) suggest a dose-response effect; for Clostridium difficile-associated diarrhoea on the other hand no dose-response was observed...
December 23, 2016: Beneficial Microbes
https://www.readbyqxmd.com/read/28002256/risk-factors-for-hospital-acquired-clostridium-difficile-infection-among-pediatric-patients-with-cancer
#13
Atsuro Daida, Hiroki Yoshihara, Ikuko Inai, Daisuke Hasegawa, Yasushi Ishida, Kevin Y Urayama, Atsushi Manabe
Hospital-acquired Clostridium difficile infection (CDI) may cause life-threatening colitis for children with cancer, making identification of risk factors important. We described characteristics of pediatric cancer patients with primary and recurring CDI, and evaluated potential risk factors. Among 189 cancer patients, 51 cases (27%) of CDI and 94 matched controls of cancer patients without CDI were analyzed. Multivariable logistic regression was used to evaluate the association between CDI and several potential risk factors...
April 2017: Journal of Pediatric Hematology/oncology
https://www.readbyqxmd.com/read/27986664/clinical-and-microbiological-characteristics-of-clostridium-difficile-infection-among-hospitalized-children-in-the-netherlands
#14
Sofie M van Dorp, Edela Smajlović, Cornelis W Knetsch, Daan W Notermans, Sabine C de Greeff, Ed J Kuijper
BACKGROUND: Little is known about pediatric Clostridium difficile infection (CDI) epidemiology. We describe the clinical and microbiological characteristics of CDI among hospitalized children in the Netherlands. METHODS: Between May 2009 and May 2015, 26 hospitals registered characteristics of pediatric (aged 2-18 years) and adult (aged 18 years) CDI in a national sentinel surveillance study. Routine polymerase chain reaction (PCR) ribotyping and multiple-locus variable-number tandem-repeat analysis (MLVA) of selected strains was performed...
January 15, 2017: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
https://www.readbyqxmd.com/read/27977555/recurrent-clostridium-difficile-infection-in-children-patient-risk-factors-and-markers-of-intestinal-inflammation
#15
Maribeth R Nicholson, Jonathan D Crews, Jeffrey R Starke, Zhi-Dong Jiang, Herbert DuPont, Kathryn Edwards
BACKGROUND: The management of Clostridium difficile infection (CDI) in children is complicated by recurrence rates of 20%-30%. The identification of risk factors associated with recurrent disease might allow early recognition of those children at highest risk. METHODS: Pediatric patients with CDI were identified through clinical laboratory records at 2 tertiary-care children's hospitals from March 2013 through May 2014. Subjects were enrolled and followed for 60 days to assess for recurrent CDI (rCDI)...
April 2017: Pediatric Infectious Disease Journal
https://www.readbyqxmd.com/read/27696233/clostridium-difficile-infection-in-children-epidemiology-and-risk-of-recurrence-in-a-low-prevalence-country
#16
MULTICENTER STUDY
A Lo Vecchio, L Lancella, C Tagliabue, C De Giacomo, S Garazzino, M Mainetti, L Cursi, E Borali, M V De Vita, E Boccuzzi, L Castellazzi, S Esposito, A Guarino
Clostridium difficile infection (CDI) is increasingly found in children worldwide, but limited data are available from children living in southern Europe. A 6-year retrospective study was performed to investigate the epidemiology, clinical features, treatment, and risk of recurrence in Italy. Data of children with community- and hospital-acquired CDI (CA-CDI and HA-CDI, respectively) seen at seven pediatric referral centers in Italy were recorded retrospectively. Annual infection rates/10,000 hospital admissions were calculated...
January 2017: European Journal of Clinical Microbiology & Infectious Diseases
https://www.readbyqxmd.com/read/27695355/influence-of-saccharomyces-boulardii-cncm-i-745on-the-gut-associated-immune-system
#17
Heike Stier, Stephan C Bischoff
BACKGROUND: The probiotic Saccharomyces boulardii CNCM I-745 (also known as Saccharomyces cerevisiae HANSEN CBS 5926; in the following S. boulardii) has proven its effectiveness in preventive and therapeutic treatment of many gastrointestinal diseases, especially diseases associated with acute diarrhea. In particular, antibiotic-associated diarrhea, Clostridium difficile-associated diarrhea, traveller's diarrhea, as well as acute diarrhea due to common viral and bacterial infections in children and adults...
2016: Clinical and Experimental Gastroenterology
https://www.readbyqxmd.com/read/27578209/epidemiology-of-diarrheal-illness-in-pediatric-oncology-patients
#18
Mohammad N Mhaissen, Alicia Rodriguez, Zhengming Gu, Haiqing Zhu, Li Tang, Yilun Sun, Stacey T Schultz-Cherry, Randall T Hayden, Elisabeth E Adderson
BACKGROUND: Diarrhea is common in children with cancer, but this has not been systematically studied to date. METHODS: Remnant stool samples collected between January 2010 and June 2011 from pediatric oncology patients with diarrhea were tested for bacterial, viral, and parasitic enteropathogens using a combination of standard-of-care (SOC) diagnostic tests, including broad-range, real-time polymerase chain reaction (PCR) assays for adenoviruses, astroviruses, and sapoviruses and 2 commercially available multiplexed PCR assays...
August 30, 2016: Journal of the Pediatric Infectious Diseases Society
https://www.readbyqxmd.com/read/27563524/hospital-acquired-clostridium-difficile-infection-in-pediatric-wards-a-retrospective-case-control-study
#19
Ayse Karaaslan, Ahmet Soysal, Nurhayat Yakut, Gulsen Akkoç, Sevliya Ocal Demir, Serkan Atıcı, Nurver Ulger Toprak, Guner Söyletir, Mustafa Bakır
BACKGROUND: Clostridium difficile is a major cause of antibiotic-associated diarrhea and frequently results in healthcare-associated infections. The aim of this study was to determine the incidence and potential risk factors for C. difficile infection (CDI) in hospitalized children who developed diarrhea. A retrospective study was performed at a university hospital in İstanbul over a three-year period (2012-2014). RESULTS: During the study period 12,196 children were hospitalized, among them 986 (8 %) children with diarrhea were investigated for CDI and 100 (0...
2016: SpringerPlus
https://www.readbyqxmd.com/read/27538503/antimicrobial-stewardship-in-paediatrics
#20
REVIEW
Nicola Principi, Susanna Esposito
BACKGROUND: Antibiotics are among the drugs most commonly prescribed to children in hospitals and communities. Unfortunately, a great number of these prescriptions are unnecessary or inappropriate. Antibiotic abuse and misuse have several negative consequences, including drug-related adverse events, the emergence of multidrug resistant bacterial pathogens, the development of Clostridium difficile infection, the negative impact on microbiota, and undertreatment risks. In this paper, the principle of and strategies for paediatric antimicrobial stewardship (AS) programs, the effects of AS interventions and the common barriers to development and implementation of AS programs are discussed...
2016: BMC Infectious Diseases
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