Factors affecting development of Clostridium difficile infection in hospitalized pediatric patients in the country Georgia

Abstract

ObjectiveMain aims of our study were to investigate occurrence of Clostridium difficile among hospitalized pediatric patients in Georgia and examine risk factors for the development of C. difficile infection. During our study we tested and piloted the real-time PCR diagnostic systems for rapid and simultaneous identification of C. difficile and number of other pathogens in our facility settings. A cross-sectional study has been performed in children less than 18 years of age in two pediatric hospitals in Georgia, between May 2016 and December 2017. Stool specimens negative by the conventional bacteriology analysis were analyzed for the presence of C. difficile and several viral and protozoa pathogens using enzyme immune assay and polymerase chain reaction. In total samples from 220 hospitalized children with gastroenteritis symptoms were analyzed in this study.ResultsThe average age of the study participants was 4.7 years. Overall 23 children were identified positive for C. difficile (10.5%). Antibiotic exposure within 2 months preceding the onset of diarrhea was associated with an increased risk of C. difficile infections. The risk was greatest with cephalosporins, followed by penicillins, carbapenems and macrolides. Clostridium difficile is an important cause of healthcare-associated diarrhea in pediatric population of Georgia.

Development of both type I–B and type II CRISPR/Cas genome editing systems in the cellulolytic bacterium Clostridium thermocellum

“…Members of the Clostridium genus have been studied for decades both as human pathogens and as industrial biocatalysts (Lynd et al., 2002; Jones et al., 2016; Xin et al., 2016; Kiu and Hall, 2018; Harris et al., 2002; Migriauli et al., 2018; Chung et al., 2014). Genetic techniques for Clostridium have lagged behind model organisms thus hindering advances in our understanding of their physiology and metabolism.…”

Risk factors for Clostridioides difficile infection in children: a systematic review and meta-analysis

“…The studies were published from 2010 to 2020 and evaluated 10,844,084 participants, of whom 31,225 had CDI. The studies had a cohort (n=9) [19, 22, 27-29, 31, 34, 35, 42], case-control (n=14) [18, 20, 21, 24-26, 30, 32, 36-41], and crosssectional design (n=2) [23,33]. Most studies (19/25) [18-23, 25-27, 29, 30, 32-34, 36, 38-40, 42] used enzyme immunoassays (EIA) or nucleic acid amplification assays to detect C. difficile toxins, and four studies [24,28,35,37] used ICD-9 or other billing codes to screen CDI patients, the remaining studies did not mention the testing method.…”

“…The studies were conducted in China, the United States, Japan, Spain, Italy, New Zealand, and other European countries. Seventeen studies [18,19,22,24,25,27,28,30,32,33,35,[37][38][39][40][41][42] were of high quality and eight studies [20,21,23,26,29,31,34,36] were of moderate quality. Assessment of methodological quality is presented in Supplementary Tables SⅡ-SⅢ.…”

Difference in Vitamin D Levels Between Children with Clostridioides difficile Enteritis and Those with Other Acute Infectious Enteritis

“…Almost all hospital-acquired infections are associated with the use of broad-spectrum antibiotics that disrupt the indigenous intestinal microbiota. CDE is the most common cause of diarrhea in hospitalized patients [ 3 ]. CDE in adults and children is accompanied by general digestive symptoms, the most common being mild to moderate diarrhea.…”

“…CDE incidence has been reported to increase with age and the increasing use of antibiotics [ 3 6 ]. However, regardless of the use of antibiotics, incidence of community-acquired C. difficile enteritis (CA-CDE) is steadily increasing in the pediatric population [ 6 7 8 ].…”