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Clostridium difficile in childrens

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...
September 30, 2016: European Journal of Clinical Microbiology & Infectious Diseases
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
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
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
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
Abolfazl Khoshdel, Karam-Ali Kasiri, Soleiman Kheiri, Roya Habibian, Narges Shojaeikhah
No abstract text is available yet for this article.
June 2016: Journal of Clinical and Diagnostic Research: JCDR
F Fenollar, P Minodier, A Boutin, R Laporte, V Brémond, G Noël, S Miramont, H Richet, S Benkouiten, J-C Lagier, J Gaudart, J-L Jouve, D Raoult
Tropheryma whipplei was detected in preliminary studies in faeces of young children with diarrhoea and also in faeces of asymptomatic persons, not only in Europe but also in Africa. In this study, the link between this bacterium and the presence of acute diarrhoea was evaluated in a large group of children. From December 2009 to January 2013, rectal swabs collected from 3796 children in the emergency departments of university hospitals in Marseille, France, were analysed: 555 children (245 female and 310 male, from 6 days to 6 years old) with acute diarrhoea defined as at least three loose stools per day for <1 week and 3241 children (1444 female and 1797 male, from 22 days to 6 years old) without diarrhoea...
July 9, 2016: Clinical Microbiology and Infection
Jae Hyun Shin, Esteban Chaves-Olarte, Cirle A Warren
Clostridium difficile is an anaerobic, Gram-positive, spore-forming, toxin-secreting bacillus that has long been recognized to be the most common etiologic pathogen of antibiotic-associated diarrhea. C. difficile infection (CDI) is now the most common cause of health care-associated infections in the United States and accounts for 12% of these infections (Magill SS et al., N Engl J Med370:1198-1208, 2014). Among emerging pathogens of public health importance in the United States, CDI has the highest population-based incidence, estimated at 147 per 100,000 (Lessa FC et al...
June 2016: Microbiology Spectrum
Maribeth R Nicholson, Gerald T Van Horn, Yi-Wei Tang, Jan Vinjé, Daniel C Payne, Kathryn M Edwards, James D Chappell
OBJECTIVE: To detect the etiologic agents of acute gastroenteritis (AGE) in children using broad molecular-based techniques, and compare clinical presentations among etiologies. STUDY DESIGN: This was a prospective population-based surveillance study of children aged <6 years with AGE conducted between 2008 and 2011 as part of the New Vaccine Surveillance Network. Stools from patients and healthy controls were tested for 21 gastrointestinal pathogens using the analyte-specific reagent Gastrointestinal Pathogen Panel and an additional reverse transcription real-time polymerase chain reaction assay for sapovirus and astrovirus...
September 2016: Journal of Pediatrics
Larry K Kociolek, Dale N Gerding, James R Osmolski, Sameer J Patel, David R Snydman, Laura A McDermott, David W Hecht
The rising incidence of Clostridium difficile infections (CDIs) in adults is partly related to the global spread of fluoroquinolone-resistant strains, namely, BI/NAP1/027. Although CDIs are also increasingly diagnosed in children, BI/NAP1/027 is relatively uncommon in children. Little is known about the antibiotic susceptibility of pediatric CDI isolates. C. difficile was cultured from tcdB-positive stools collected from children diagnosed with CDI between December 2012 and December 2013 at an academic children's hospital...
August 2016: Antimicrobial Agents and Chemotherapy
Mohammad AlGhounaim, Yves Longtin, Milagros Gonzales, Joanna Merckx, Nicholas Winters, Caroline Quach
BACKGROUND Polymerase chain reaction (PCR) assays based on the detection of the toxin B gene are replacing enzyme-linked immunosorbent assay (ELISA)-based toxin production detection or cell cytotoxicity assay in most laboratories. OBJECTIVE To determine the proportion of pediatric patients diagnosed with Clostridium difficile infection by PCR who would have also been diagnosed by ELISA and to compare the clinical characteristics of PCR+/ELISA+ vs PCR+/ELISA- patients. METHODS Using the microbiology laboratory information system, stool samples positive for C...
September 2016: Infection Control and Hospital Epidemiology
Daniel J Adams, Matthew D Eberly, Anthony Goudie, Cade M Nylund
OBJECTIVE: Vancomycin-resistant Enterococcus (VRE) is an emerging drug-resistant organism responsible for increasing numbers of nosocomial infections in adults. Few data are available on the epidemiology and impact of VRE infections in children. We hypothesized a significant increase in VRE infections among hospitalized children. Additionally, we predicted that VRE infection would be associated with certain comorbid conditions and increased duration and cost of hospitalization. METHODS: A retrospective study of inpatient pediatric patients was performed using data on hospitalizations for VRE from the Healthcare Cost and Utilization Project Kids' Inpatient Database from 1997 to 2012...
July 2016: Hospital Pediatrics
Michela Cappella, Fabrizio Pugliese, Andrea Zucchini, Federico Marchetti
Reactive arthritis is a rare complication of Clostridium difficile enterocolitis, especially in children. We review the 6 pediatric cases published in the English and non-English literature and discuss their clinical presentation, outcome, treatment, and pathophysiology. We also report the seventh case of Clostridium difficile reactive arthritis in a 6-year-old boy who was treated with amoxicillin-clavulanate for 10 days because of an upper respiratory infection. After the antibiotic course, the child developed at the same time diarrhea with positive stool culture for Clostridium difficile and an asymmetric polyarthritis...
2016: Case Reports in Pediatrics
Larry K Kociolek, Maria Bovee, Donna Carter, Jody D Ciolino, Rupal Patel, Anna O'Donnell, Angela H Rupp, Xiaotian Zheng, Stanford T Shulman, Sameer J Patel
BACKGROUND: Although Clostridium difficile infections (CDIs) are increasingly diagnosed in children, many children diagnosed with CDI lack classic risk factors. Frequent use of highly sensitive tcdB polymerase chain reaction (PCR) testing in low-risk patients leads to CDI misdiagnosis and unnecessary CDI antibiotic use in children with C difficile carriage. METHODS: For this quasi-experimental study, we developed and implemented an educational intervention (EI) to inform healthcare providers (HCPs) about tcdB PCR test limitations...
May 17, 2016: Journal of the Pediatric Infectious Diseases Society
Daniel B Horton, Brian L Strom, Mary E Putt, Carlos D Rose, David D Sherry, Julia S Sammons
IMPORTANCE: The incidence of Clostridium difficile infection has increased among children. The epidemiology of pediatric C difficile infection-associated reactive arthritis is poorly understood. OBJECTIVE: To characterize the incidence, recognition, and distinguishing clinical features of pediatric C difficile infection-associated reactive arthritis among children with C difficile infection. DESIGN, SETTING, AND PARTICIPANTS: In this cohort and nested case-control study using electronic health records from January 1, 2004, to December 31, 2013, across 3 geographically diverse pediatric health care networks, we screened for reactive arthritis among 148 children between ages 2 and 21 years with diagnostic or procedural codes suggesting musculoskeletal disease associated with C difficile diagnosis or positive testing...
July 5, 2016: JAMA Pediatrics
Elena Borali, Costantino De Giacomo
Clostridium difficile is a sporogenic, anaerobic, Gram-positive, emerging enteric pathogen. It represents the most common cause of healthcare-associated diarrhoea in the United States, with significantly associated morbidity, mortality and healthcare costs. Historically regarded as a little more than an innocent colonizer bystander of the gastrointestinal tract of children, Clostridium difficile has increasingly demonstrated its behavior as a true pathogen in the paediatric age groups. This organism may be responsible for a broad spectrum of diseases in children, ranging from self-limiting secretory diarrhoea to life-threatening conditions, such as pseudomembranous colitis, toxic megacolon, intestinal perforation and septic shock...
May 13, 2016: Journal of Pediatric Gastroenterology and Nutrition
Chris Stockmann, Andrew T Pavia, Brad Graham, Mike Vaughn, Rob Crisp, Mark A Poritz, Stephanie Thatcher, E Kent Korgenski, Trenda Barney, Judy Daly, Margarita Rogatcheva
KEY POINTS: In the era of widespread rotavirus vaccine use, toxigenic Clostridium difficile, diarrheagenic Escherichia coli, and viruses (particularly norovirus) are commonly detected among children with infectious gastroenteritis in the United States by using a multipathogen molecular panel. BACKGROUND: Diarrheal diseases are a major cause of ambulatory care visits and hospitalizations among children. Because of overlapping signs and symptoms and expensive and inefficient testing methods, the etiology of pediatric diarrhea is rarely established...
May 4, 2016: Journal of the Pediatric Infectious Diseases Society
Elyse M Schwab, Jacob Wilkes, Kent Korgenski, Adam L Hersh, Andrew T Pavia, Vanessa W Stevens
OBJECTIVE: The purpose of this study was to identify the risk factors during the incident Clostridium difficile infection (CDI) episode, associated with developing recurrent CDI within 60 days, among hospitalized children that may be amenable to intervention. METHODS: This was a retrospective cohort study of pediatric patients hospitalized at a freestanding children's hospital from January 1, 2003, to December 31, 2010. Patients were eligible if they were <18 years of age at admission and had a new diagnosis of CDI...
June 2016: Hospital Pediatrics
E A Lees, F Miyajima, M Pirmohamed, E D Carrol
Clostridium difficile is an important nosocomial pathogen in adults. Its significance in children is less well defined, but cases of C. difficile infection (CDI) appear to be increasingly prevalent in paediatric patients. This review aims to summarize reported Clostridium difficile carriage rates across children of different age groups, appraise the relationship between CDI and factors such as method of delivery, type of infant feed, antibiotic use, and co-morbidities, and review factors affecting the gut microbiome in children and the host immune response to C...
July 2016: European Journal of Clinical Microbiology & Infectious Diseases
Thomas J Sandora, Monica Fung, Patrice Melvin, Dionne A Graham, Shawn J Rangel
IMPORTANCE: Appropriate use of surgical antibiotic prophylaxis (AP) reduces surgical site infection rates, but prior data suggest variability in use patterns. OBJECTIVE: To assess national variability and appropriateness of AP in pediatric surgical patients. DESIGN, SETTING, AND PARTICIPANTS: Retrospective cohort study of 31 freestanding children's hospitals in the United States using administrative data from 2010-2013. The study included 603 734 children younger than 18 years who underwent one of the 45 most commonly performed operations...
June 1, 2016: JAMA Pediatrics
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