Prevalence and Toxigenicity of &lt;i&gt;Clostridium difficile&lt;/i&gt; Isolates in Fecal Microflora of Preterm Infants in the Intensive Care Nursery

El-Mohandes, Ayman E.; Keiser, John; Refat, Mamdouh; Jackson, Barbara

doi:10.1159/000243935

Cited by 29 publications

(25 citation statements)

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“…In our study, the C. difficile prevalence rate was 35-53%, which is comparable with the rates reported in previous studies of 33-90% [6,[18][19][20]26,27]. The rates of CDC increased gradually over the course of hospitalization, which has been consistently reported among researchers and suggest that the hospital-acquired mode of C. difficile transmission is similar to that of later times of life.…”

Section: Discussionsupporting

confidence: 90%

“…Meanwhile, the proportion of toxin positivity as assessed by PCR assays using total bacterial genomic DNA as a template was 25-37.5%, which corresponded to the lowest value reported in previous studies (33-100%) using both culture and direct fecal cytotoxin detection in cultured cells [10,19,26]. It has been reported that many asymptomatic infants under 2 years of age are frequently colonized with both nontoxigenic and toxigenic strains [10,38].…”

Section: Discussionmentioning

confidence: 72%

“…The present study monitored the CDC pattern and its toxin status in preterm infants in the NICU, which has been infrequently investigated in the literature, including only a single study from Korea [6,19,20,26,27]. In addition, to the best of our knowledge, this is one of the first reports revealing that EBMF during the first week of life may have protective effects against persistent CDC in preterm infants.…”

Section: Discussionmentioning

confidence: 99%

“…In addition, to the best of our knowledge, this is one of the first reports revealing that EBMF during the first week of life may have protective effects against persistent CDC in preterm infants. Several studies have investigated the beneficial role of breast-milk feeding on CDC in term infants; however, its effects have been rarely investigated in hospitalized preterm infants, excluding one study that revealed no significant association between breast-milk feeding and CDC [19,28,29].…”

Section: Discussionmentioning

confidence: 99%

“…However, the results of these previous studies are inconsistent, in contrast with those of studies of healthy term infants [15][16][17]. Moreover, CDC and its related factors in preterm infants have not been fully investigated because many studies did not differentiate between different species of the genus Clostridium [6,18,19]. In Korea, to our knowledge, only one study investigated CDC in preterm infants [20].…”

Section: Introductionmentioning

confidence: 99%

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Monitoring ofClostridium difficileColonization in Preterm Infants in Neonatal Intensive Care Units

Chang

Shim

et al. 2012

Pediatr Gastroenterol Hepatol Nutr

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Section: Discussionsupporting

confidence: 90%

Section: Discussionmentioning

confidence: 72%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Monitoring ofClostridium difficileColonization in Preterm Infants in Neonatal Intensive Care Units

Chang

Shim

et al. 2012

Pediatr Gastroenterol Hepatol Nutr

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Clostridium difficile Infection in Children

Sammons¹,

Toltzis²,

Zaoutis³

2013

JAMA Pediatr

100

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Clostridium difficile is the most common cause of health care-associated diarrhea among adults in the United States and is associated with significant morbidity and mortality. During the past decade, the epidemiology of C difficile infection (CDI) has changed, including a rise in the rate and severity of infection related to the emergence of a hypervirulent strain as well as an increase in disease among outpatients in community settings. Although less is known about CDI among pediatric patients, C difficile is increasingly recognized as an important pathogen among children. In this review, we discuss recent updates in the incidence and epidemiology of CDI among children, including risk factors for infection, and highlight the importance of CDI in special populations of children, particularly those with inflammatory bowel disease or cancer. In addition, we review current knowledge in the areas of diagnosis and management of CDI among children and highlight future areas for research.

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Prevalence of Detection of Clostridioides difficile Among Asymptomatic Children

et al. 2021

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IMPORTANCE Detection of Clostridioides difficile has frequently been described in asymptomatic infants and children, but accurate estimates across the age spectrum are unavailable. OBJECTIVE To assess the prevalence of C difficile detection among asymptomatic children across the age spectrum. DATA SOURCES This systematic review and meta-analysis included a search of the Cochrane Central Register of Controlled Trials, MEDLINE, Embase, CINAHL, Scopus, and Web of Science for articles published from January 1, 1990, to December 31, 2020. Search terms included Clostridium difficile, Peptoclostridium difficile, Clostridioides difficile, CDF OR CDI OR c diff OR c difficile, Clostridium infections OR cd positive diarrhea OR cd positive diarrhea OR Clostridium difficile OR Peptoclostridium difficile OR pseudomembranous colitis OR pseudomembranous enterocolitis, enterocolitis, and pseudomembranous. These were combined with the following terms: bacterial colonization and colonization OR colonized OR colonizing OR epidemiology OR prevalence OR seroprevalence. STUDY SELECTION Studies were screened independently by 2 authors. Studies were included if they reported testing for C difficile among asymptomatic children (ie, children without diarrhea) younger than 18 years.DATA EXTRACTION AND SYNTHESIS Data were extracted independently and in duplicate by 2 reviewers. Preferred Reporting Items for a Systematic Review and Meta-analysis (PRISMA) guidelines were used. Data were pooled using a random-effects model. MAIN OUTCOMES AND MEASURESThe primary outcome was prevalence of C difficile detection among asymptomatic children. Secondary outcomes included prevalence of toxigenic vs nontoxigenic strains of C difficile and prevalence of C difficile detection stratified by geographic region, income status, testing method, and year of testing. RESULTS A total of 95 studies with 19 186 participants were included. Rates of detection of toxigenic or nontoxigenic C difficile were greatest among infants aged 6 to 12 months (41%; 95% CI, 32%-50%) and decreased to 12% (95% CI, 7%-18%) among children aged 5 to 18 years. The prevalence of toxigenic C difficile colonization was lower, peaking at 14% (95% CI, 8%-21%) among infants aged 6 to 12 months and decreasing to 6% (95% CI, 2%-11%) among children older than 5 years. Although prevalence differed by geographic region (ie, North and South America vs Europe: β, −0.151, P = .001; North and South America vs Western Pacific: β, 0.136, P = .007), there was no difference by testing method (ie, culture vs polymerase chain reaction: β, 0.069, P = .052; culture vs enzyme immunoassay: β, −0.178, P = .051), income class (low-middle income vs high income: β, −0.144, P = .23; upper-middle vs high income: β, −0.020,

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Prevalence and Toxigenicity of <i>Clostridium difficile</i> Isolates in Fecal Microflora of Preterm Infants in the Intensive Care Nursery

Cited by 29 publications

References 10 publications

Monitoring ofClostridium difficileColonization in Preterm Infants in Neonatal Intensive Care Units

Monitoring ofClostridium difficileColonization in Preterm Infants in Neonatal Intensive Care Units

Clostridium difficile Infection in Children

Prevalence of Detection of Clostridioides difficile Among Asymptomatic Children

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