Because of the relatively poor response to therapy, additional approaches to prevention and/or treatment of C. difficile colitis appear to be warranted.
Only 23.2% of 259 patients admitted with a CAP syndrome had documented bacterial infection; another 26.6% had no identified bacterial etiology, but findings closely resembled those of bacterial infection. Nevertheless, all 259 received antibacterial therapy. Careful attention to the clinical picture may identify uninfected patients or those with viral infection, perhaps with reassurance by a non-elevated procalcitonin. Determining an etiologic diagnosis remains elusive. Better discriminators of bacterial infection are sorely needed.
Helicobacter pylori infection was examined among 356 asymptomatic white Hispanic and black children aged 2--16 years attending 13 licensed day care centers in Houston. Demographic information and socioeconomic factors were evaluated. H. pylori status was determined by (13)C-urea breath testing. The prevalence of active H. pylori infection was 24% and increased with age. Prevalence was almost identical among white Hispanic and black children. Children living in the most crowded conditions were at the greatest risk for H. pylori acquisition, and an inverse correlation was seen between the mother's education and H. pylori positivity in children. Breast-feeding played a protective role against the acquisition of H. pylori infection. Understanding the epidemiology of H. pylori infection in childhood requires better understanding of the interactions between environment, ethnic group, and socioeconomic conditions.
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