Clinical Characteristics of Symptomatic<i>Clostridium difficile</i>Infection in Children: Conditions as Infection Risks and Whether Probiotics Is Effective

Na, Jae Yoon; Park, Jong Mo; Lee, Kyung Suk; Kang, Jung Oak; Oh, Sung Hee; Kim, Yong Joo

doi:10.5223/pghn.2014.17.4.232

Cited by 15 publications

(14 citation statements)

References 28 publications

(28 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…One meta-analysis has suggested that probiotics prophylaxis can result in a large reduction in CDI without increasing clinically important adverse events [25]. On the other hand, other researchers have suggested that routine use of probiotics might not be effective in preventing CDI [2627]. In the present study, colonization of C. difficile was not associated with the use of probiotics.…”

Section: Discussioncontrasting

confidence: 44%

Effect of Metronidazole in Infants with Bowel Habit Change: Irrelative to theClostridium difficileColonization

Kim

Lee

Tchah

et al. 2017

Pediatr Gastroenterol Hepatol Nutr

View full text Add to dashboard Cite

PurposeClinical symptoms associated with Clostridium difficile infection (CDI) can vary widely. Carrier state without apparent symptoms is relatively common during infancy. The objective of this study was to determine the association of C. difficile colonization with bowel habit change and the effect of C. difficile colonization treatment on restoration of normal bowel habit.MethodsBetween 2006 and 2014, infants at 1 to 12 months of age with diarrhea for more than 2 weeks who did not improve with conservative care were recruited from Gachon University Gil Medical Center. Infants who were followed up for at least 7 days were included. The presence or absence of C. difficile colonization, effect of metronidazole, and other medical records were reviewed. To determine the association between CDI and bowel habit change, logistic regression analysis was used.ResultsOf a total of 126 infants, 74 (58.7%) were male patients. Of the 126 patients, 27 (21.4%) had C. difficile colonization. Significant (p<0.05) risk factors for C. difficile colonization included artificial milk feeding (odds ratio [OR], 4.310; 95% confidence interval [CI], 1.564-11.878), prior rotavirus vaccination (OR, 4.322; 95% CI, 1.018-18.349), and antibiotic use (OR, 4.798; 95% CI, 1.430-16.101). There was improvement in bowel habit after metronidazole therapy (OR, 0.34; 95% CI, 0.15-0.79; p<0.05), regardless of the presence or absence of C. difficile colonization.ConclusionThere was no significant correlation between bowel habit change and C. difficile colonization during infancy. However, metronidazole can be used as an optional method to manage functional gastrointestinal disorders.

show abstract

Section: Discussioncontrasting

confidence: 44%

Effect of Metronidazole in Infants with Bowel Habit Change: Irrelative to theClostridium difficileColonization

Kim

Lee

Tchah

et al. 2017

Pediatr Gastroenterol Hepatol Nutr

View full text Add to dashboard Cite

show abstract

“…There is growing evidence that C. difficile is associated with diarrhea and increased lengths of hospital stays in children under 2 years of age535455. C. difficile infections may be underreported in this population, as it is often not associated with the severe outcomes observed in infected adults such as colon resection and mortality53.…”

Section: Discussionmentioning

confidence: 99%

Milk Fat Globule Membrane Supplementation in Formula Modulates the Neonatal Gut Microbiome and Normalizes Intestinal Development

Bhinder

Allaire

Garcia

et al. 2017

Sci Rep

140

108

View full text Add to dashboard Cite

Breast milk has many beneficial properties and unusual characteristics including a unique fat component, termed milk fat globule membrane (MFGM). While breast milk yields important developmental benefits, there are situations where it is unavailable resulting in a need for formula feeding. Most formulas do not contain MFGM, but derive their lipids from vegetable sources, which differ greatly in size and composition. Here we tested the effects of MFGM supplementation on intestinal development and the microbiome as well as its potential to protect against Clostridium difficile induced colitis. The pup-in-a-cup model was used to deliver either control or MFGM supplemented formula to rats from 5 to 15 days of age; with mother’s milk (MM) reared animals used as controls. While CTL formula yielded significant deficits in intestinal development as compared to MM littermates, addition of MFGM to formula restored intestinal growth, Paneth and goblet cell numbers, and tight junction protein patterns to that of MM pups. Moreover, the gut microbiota of MFGM and MM pups displayed greater similarities than CTL, and proved protective against C. difficile toxin induced inflammation. Our study thus demonstrates that addition of MFGM to formula promotes development of the intestinal epithelium and microbiome and protects against inflammation.

show abstract

“…Promising, but conflicting, results of efficacy have been shown in the adult population receiving S. boulardii or a mix of Lactobacilli. [37][38][39][40][41] However, in pediatric age the evidence is limited to case reports, 42,43 and RCTs that include the treatment of CDI as primary outcome are still lacking.…”

Section: Treatmentmentioning

confidence: 99%

Probiotics for Prevention and Treatment of Diarrhea

Guarino

Guandalini

Vecchio

2015

Journal of Clinical Gastroenterology

155

View full text Add to dashboard Cite

Probiotics are increasingly used for prevention and treatment of diarrhea more in children than in adults. Given the broad spectrum of diarrhea, this review focuses on the main etiologies: acute gastroenteritis, antibiotic-associated diarrhea (AAD), and necrotizing enterocolitis (NEC). For each, we reviewed randomized controlled trials, meta-analyses, and guidelines. For acute gastroenteritis we found 12 guidelines: 5 recommended probiotics and 7 did not. However, the guidelines containing positive recommendations provided proof of evidence from clinical trials and meta-analyses. Lactobacillus rhamnosus GG (LGG) and Saccharomyces boulardii had the most compelling evidence of efficacy as they reduced the duration of the disease by 1 day. For AAD 4 meta-analyses were found, reporting variable efficacy of probiotics in preventing diarrhea, based on the setting, patient's age, and antibiotics. The most effective strains were LGG and S. boulardii. For NEC, we found 3 randomized controlled trials, 5 meta-analyses, and 4 position papers. Probiotics reduced the risk of NEC enterocolitis and mortality in preterm babies. Guidelines did not support a routine use of probiotics and asked for further data for such sensitive implications. In conclusion, there is strong and solid proof of efficacy of probiotics as active treatment of gastroenteritis in addition to rehydration. There is solid evidence that probiotics have some efficacy in prevention of AAD, but the number needed to treat is an issue. For both etiologies LGG and S. boulardii have the strongest evidence. In NEC the indications are more debated, yet on the basis of available data and their implications, probiotics should be carefully considered.

show abstract

Clinical Characteristics of SymptomaticClostridium difficileInfection in Children: Conditions as Infection Risks and Whether Probiotics Is Effective

Cited by 15 publications

References 28 publications

Effect of Metronidazole in Infants with Bowel Habit Change: Irrelative to theClostridium difficileColonization

Effect of Metronidazole in Infants with Bowel Habit Change: Irrelative to theClostridium difficileColonization

Milk Fat Globule Membrane Supplementation in Formula Modulates the Neonatal Gut Microbiome and Normalizes Intestinal Development

Probiotics for Prevention and Treatment of Diarrhea

Contact Info

Product

Resources

About