Prevalence of Clostridium spp. and Clostridium difficile in children with acute diarrhea in São Paulo city, Brazil (original) (raw)
Related papers
Incidence and importance of Clostridium difficile in paediatric diarrhoea in Brazil
Journal of Medical Microbiology, 2003
Clostridium difficile strains were detected in 14 of 210 (6 . 7 %) faecal samples from children in Rio de Janeiro, Brazil, by cultivating faeces on cycloserine/cefoxitin/fructose agar after alcohol-shock. Two main groups of children were studied: inpatients (n ¼ 96) and outpatients (n ¼ 114). The inpatient group consisted of children on antibiotics or immunosuppressors who presented with diarrhoea and other children who did not present with diarrhoea and were not under an antibiotic or chemotherapeutic regimen. Among the outpatients, two groups were examined: namely, a group that comprised children who presented with diarrhoea and were occasionally under an antibiotic regimen and another group that comprised patients who were not taking antibiotics. After cytotoxic assay, toxigenic C. difficile (Cd tox þ ) strains were detected in 4 . 2 % of inpatients and 3 . 5 % of outpatients. Exclusion of other infectious causes of diarrhoea indicated a typical case of C. difficileassociated paediatric diarrhoea in the community. Among Cd tox þ isolates, no variations were detected by PCR for toxin A that employed primers NK9 and NKVO11. No resistance was found to metronidazole or vancomycin among strains that were isolated from children who presented with diarrhoea, but the MIC 50 and MIC 90 values for clindamycin were 6-8 and 16 ìg ml À1 , respectively. Resistance to clindamycin seems to be more disseminated in strains from outpatients than in those from inpatients (P , 0 . 05). In conclusion, these data suggest that investigation for C. difficile infection should be taken into account in paediatric diarrhoea in both inpatients and outpatients in developing countries.
Human pathology, 2010
Clostridium difficile toxin is frequently found in the stool of children; however, pseudomembranous colitis is rare. Studying the usefulness of Clostridium difficile toxin assays in pediatrics is required. We performed a correlation between presence of Clostridium difficile toxin in stool and evidence of Clostridium difficile in gastrointestinal pediatric tissue samples using immunohistochemistry (with a pan-clostridial antibody) and polymerase chain reaction (with primers for toxin genes). We studied 11 patients with a median age of 8 years (range, 4 weeks to 17 years); 4 (36%) were female. The median time between detection of Clostridium difficile toxin in stool and obtaining tissue was 3 days. Ten patients survived. Endoscopy was performed in 8 survivors and showed normal mucosa in 2, pseudomembranes in 2, erythema and friability in 1, aphthae in 1, increased mucous production in 1, and colitis in 1. Two survivors underwent laparotomy for either obstruction or resection of necrot...
European Journal of Clinical Microbiology, 1987
the presence of its cytotoxin in infants and older children was examined to determine its role in diarrheal disease. Cytotoxin was more closely associated with cases of diarrhea, both in infants and in children than the microorganism, although not significantly. The isolates were typed by means of sensitivity to bacteriophages and bacteriocins and their cytotoxigenic potential was also determined. Less than 30 % of the colonized patients had toxigenic strains. A study of strain variability over a four-year period in the same hospital showed that two bacteriophage-bacteriocin types and non-toxigenie strains predominated. The common presence of non-toxigenic strains could explain in part the lack of correlation between isolation of Clostridium difficile and diarrhea. Most of the non-toxigenic strains showed moderate resistance to tetracycline, a property which might explain their ability to persist for long periods in the hospital.
Clinical Microbiology and Infection, 2001
Objectives To characterise genotypes of Clostridium difficile strains isolated from asymptomatic individuals and patients with diarrhea. Methods Fecal specimens from 235 asymptomatic infants <12 months, 76 asymptomatic children 1-11 years and 132 adult patients with antibiotic-associated and non-antibiotic-associated diarrhea obtained from Siriraj Hospital, Bangkok from October 1998 to April 1999 were examined for C. difficile by cycloserine-cefoxitin-fructose agar culture. The presence of the C. difficile toxin A gene was determined by specific PCR with the use of primers 5-(CCC AATAGA AGATTC AATATTAAG CTT)-3 and 5-(GGA AGA AAA GAA CTT CTG GCT CAC TCA GGT)-3. All C. difficile isolates were subsequently genotyped by pulsed-field gel electrophoresis (PFGE). Results The C. difficile strains were found in 28 (11.9%) asymptomatic infants, 16 (21.1%) asymptomatic children and 33 (25%) adult patients. In total, 14 PFGE types and eight subtypes designated as types A
Laboratory diagnosis of Clostridium difficile-associated diarrhoea: a plea for culture
Journal of medical microbiology, 2005
A routine protocol for diagnosing Clostridium difficile-associated diarrhoea (CDAD) based on both faecal-cytotoxin detection and toxigenic culture was adopted by the microbiology laboratory of the St Luc-UCL University Hospital in Brussels in 1997. A toxigenic culture is a faecal culture followed, in the case of positivity, by a direct immunoassay on colonies to detect toxin A production. The results obtained over the past 7 years in the hospital are reviewed here. A total of 10,552 diarrhoeal stools from 7042 patients were analysed, of which 9494 were negative for all tests. A total of 1058 samples (10 %) from 794 patients were culture-positive, of which 460 (4.4 %) were positive for a faecal cytotoxin. The remaining 598 cultures were tested for toxin A on colonies; 355 of them were positive, which is 3.4 % of the total, and the remaining 243 (2.3 %) were negative. The positivity of the faecal-cytotoxin assay was statistically linked to the number of colonies observed on the cultur...
International Journal of Current Microbiology and Applied Sciences, 2016
Injudicious use of antibiotics in hospitalized patients increases the risk of Clostridium difficile associated diarrhea (CDAD). This study was conducted to determine the incidence of C. difficile as a cause of antibiotic associated diarrhea in pediatric patients in our hospital. Sixty infants and children with a history of antibiotic intake whether having diarrhea or not and 30 age and sex matched patients with no history of antibiotic intake were studied prospectively over a period of one year. Stool samples were processed for C. difficile isolation and examined for C. difficile toxin A and B by the enzyme-linked immunosorbent assay. 26 out of 60 cases (43.3%) suffered from diarrhea. Only (22/60) showed positive stool culture for C. difficile, 18 out of them had diarrhea while the remaining 4 patients had no diarrhea and only colonized with toxigenic C. difficile representing 11.8% of total 34 cases without diarrhea. Toxin A and B were detected in 16 patients including 4 asymptomatic carriers and 12 out of 26 cases with diarrhea representing 46.2%. The incidence of CDAD in our hospital was 46.2%. The asymptomatic carriage rate was 11.8%.
Diagnosis of Clostridium difficile infection in patients with hospital-acquired diarrhea
2018
Clostridium difficile infection (CDI) is a rapidly emerging infection that may have devastating consequences. Prompt and accurate diagnosis is crucial for management and control. The aim of this study was to determine the incidence of C. difficile associated diarrhea among hospitalized patients, and to compare different diagnostic laboratory methods for detection of toxin producing strains in clinical specimens. The study was conducted at a university hospital in Cairo during the period from May 2013 till June 2015. Subjects were under antibiotic therapy and presented with hospital-acquired diarrhea. Four hundred and sixty-five stool specimens were processed by different microbiological methods. C. difficile was recovered in culture in 51 of stool specimens. Of these, 86.3% to 98% were positive for toxin production by 2 different methods. This study showed that antibiotic intake is the major risk factor for development of hospital-acquired diarrhea. We evaluated different microbiological methods for diagnosis of C. difficile. We recommend the use of toxigenic culture as a gold standard for microbiological diagnosis of C. difficile.
Diyala Journal of Medicine
Background: Clostridium difficile is a gram positive anaerobic spore forming bacteria. C. difficile-associated disease is a critical clinical issue that is accepted to happen mainly after hospitalization and used of expansive range anti-infection agents. Objective:To define the rate of C. difficile infections isolated from children patients suffering from diarrhea, detection profile toxigenicity of C. difficile strains for toxin A and toxin B by using of PCR, and revise different risk factors of C. difficile infections. Patients and Methods: This cross-sectional study included 50 patients who hospitalized for at least 2 days before the appearance of three or more unformed or liquid stools for 24h, genomic DNA was extracted by using 10% fecal supernatant and a ready kit was used for extraction according to manufacturer instructions. Molecular detection of toxigenic C. difficile done by using the specific primer sequences in polymerase chain reaction. Results: Current study showed diarrhea was the most prominent complain among the study population accounting for 41(82%), of whom 39(78%) presented with watery diarrhea. 38(76%) patients had no fever. The most comorbid disease was inflammatory bowel disease (IBD) with 7 (14%) patients. Forty-six (92%) cases had no history of hospitalization in the last 3 months versus only 8% had such history. PCR revealed that 16 (32%) samples were positive for tcdB gene, while all samples were negative for genes tcdA.
2022
Clostridioides difficile infection (CDI) is a major cause of antibiotic-associated diarrhea and an unappreciated contributor to child mortality in low-and middle-income countries where diagnosis may be difficult. There is little information about the prevalence of CDI among infants, children, and adolescents in Africa. Seventy-six samples were collected from pediatric patients presenting with diarrhea, including infants (≤ 2 years old), children (2-12 years) and adolescents (13 ≤17 years) from three hospitals between January and December 2019. Demographic data, medical history and prior antibiotic use were recorded. Toxigenic culture and PCR were used to detect and validate the presence of C. difficile in the samples. A total of 29 (38.7%), 39 (52.0%) and 7 (9.3%) samples were from infants, children, and adolescents, respectively. Average age of the patients was 4.4 years. Of these samples, 31 (41%) were positive for C. difficile by culture and were verified by PCR amplification of C. difficile specific genes (tcdA and tcdB). Most positive cases were children (53.3%) and infants (40.0%) with the majority of them residing in the urban areas. Forty-nine (66.2%) of the patients had no known antibiotics exposure, whereas 29.0% and 29.7% reported use of over-the-counter antibiotics at 14 and 90 days, prior to the hospital visit, respectively. CDI is relatively common among children with diarrhea in Northern Nigeria. Therefore, for effective management and treatment, more attention should be given to testing for C. difficile as one of the causative agents of diarrhea.