Incidence and Origin of Clostridium Difficile in the Neonate

Al-Jumaili, I J

doi:10.1097/00006454-198405000-00041

Cited by 12 publications

(15 citation statements)

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“…C. difficile is common commensal organism in infancy. 24–30 The age at which C. difficile become pathologic is unclear but likely after the first year of life. 7, 31 We excluded children less than one year of age in an effort to avoid misclassification bias.…”

Section: Discussionmentioning

confidence: 99%

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Clostridium difficile Infection in Hospitalized Children in the United States

Nylund¹,

Goudie²,

Garza³

et al. 2011

Arch Pediatr Adolesc Med

186

158

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Section: Discussionmentioning

confidence: 99%

“…There is substantial evidence to support C. difficile as both normal commensal flora and non-pathogenic in infants less than one year of age. 7, 24–31 …”

Section: Methodsmentioning

confidence: 99%

Clostridium difficile Infection in Hospitalized Children in the United States

Nylund¹,

Goudie²,

Garza³

et al. 2011

Arch Pediatr Adolesc Med

186

158

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“…children under 1 month old [11]. A recent study of neonates in a special-care nursery showed that 7% of infants aged 1 day, 54% of infants aged from 1-5 days, and 90% of those between 6 and 35 days yielded C. difficile on stool culture [1].…”

Section: Difficilementioning

confidence: 99%

“…Although it is has been speculated that infants may be colonised by the organism during delivery [6], vaginal swabs, collected just before delivery, were uniformly negative for C. difficile [1]. This led to the conclusion that infection is mainly from environmental sources, rather than of maternal origin.…”

Section: Difficilementioning

confidence: 99%

Significance of Clostridium difficile and its cytotoxin in children

et al. 1986

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Stools of 147 children belonging to different age groups were examined for the presence of Clostridium difficile, its cytotoxin and other enteric pathogens. None of the 31 full-term neonates, 5 (16%) of the 32 premature neonates, 27 (46%) of the 59 infants and 1 (4%) of the 25 older children excreted C. difficile in their stools. Faecal cytotoxin was only detected in four infants (7%). There was no correlation with diarrhoea, previous antibiotic therapy, type of diet, or the concomitant presence of other intestinal pathogens. We conclude that colonisation of the intestine by C. difficile is probably acquired from environmental sources and that it cannot be regarded as a significant cause of diarrhoea in children.

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“…1 Traditionally, it was thought to be nonpathogenic in infants and young children 2, 3 because the pathogen and even its toxins can be found in the stool of up to 70% of asymptomatic neonates. 4–6 However, recent studies suggest that C. difficile is a bona fide cause of disease in children and patients with no known risk factors, such as antibiotic or healthcare exposure. 7–11 Emergency room visits and hospitalizations with C difficile infection in children are increasing, 12–14 and recent data suggest that C difficile infection is a risk factor for pediatric in-hospital mortality.…”

mentioning

confidence: 99%

Intestinal Inflammatory Biomarkers and Outcome in Pediatric Clostridium difficile Infections

Feghaly¹,

Stauber²,

Tarr³

et al. 2013

The Journal of Pediatrics

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Objectives To identify specific fecal biomarkers for symptomatic Clostridium difficile infection and predictors of poor outcomes. Study design We enrolled children with positive C. difficile testing (cases) and symptomatic controls. We also analyzed stool samples from colonized and non-colonized asymptomatic children. We performed enzyme immunoassays (EIA) to determine fecal interleukin (IL)-8, lactoferrin and phosphorylated-p38 protein concentrations, and quantitative polymerase chain reactions (PCR) to determine IL-8 and CXCL-5 RNA relative transcript abundances, and C. difficile bacterial burden. Results Of 68 asymptomatic controls, 16 were colonized with C. difficile. Phosphorylated-p38 was specific for C difficile infection but lacked sensitivity. Fecal cytokines were elevated in samples from symptomatic children, whether cases or controls. In children with C difficile infection, fecal CXCL-5 and IL-8 mRNA abundances at diagnosis correlated with persistent diarrhea after five days of C difficile infection therapy and with treatment with vancomycin. When children with concomitant viral gastroenteritis were excluded, these correlations persisted. Time-to-diarrhea resolution was significantly longer in patients with elevated fecal cytokines at diagnosis. A logistic regression model identified high CXCL-5 mRNA abundance as the only predictor of persistent diarrhea. Conversely, fecal C. difficile bacterial burden was not different in symptomatic and asymptomatic children and did not correlate with any clinical outcome measure. Conclusions Fecal inflammatory cytokines may be useful in distinguishing C. difficile colonization from disease and identifying children with C difficile infection likely to have prolonged diarrhea.

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Incidence and Origin of Clostridium Difficile in the Neonate

Cited by 12 publications

References 0 publications

Clostridium difficile Infection in Hospitalized Children in the United States

Clostridium difficile Infection in Hospitalized Children in the United States

Significance of Clostridium difficile and its cytotoxin in children

Intestinal Inflammatory Biomarkers and Outcome in Pediatric Clostridium difficile Infections

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