Prevalence of Clostridium difficile Among Healthy Chilean Infants: Evaluation by Commercial Enzyme Immunoassay Versus Standard Cytotoxin Assay

Montero, M.; Lobos, T; Valenzuela, A.; Roos, Orietta; Rodríguez, Luis Ramón Ruiz; Piemonte, Paula; Giglio, M

doi:10.1093/clinids/20.supplement_2.s259

Cited by 2 publications

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“…Age groups included neonates (n = 13); infants (n = 24); and children 2 years or younger (n = 12), 3 years or younger (n = 3), 5 years or younger (n = 2), 8 years or younger (n = 2), 10 years or younger (n = 1), and older than 10 years (n = 32) . Seventy-seven studies included healthy children; other populations were premature or low-birth-weight infants (n = 6), patients with oncologic or hematologic disease (n = 9), patients with a diagnosis of malnourishment (n = 1), and outpatients attending gastroenterology clinics without C difficile –associated clinical symptoms (n = 2) (eTable 2 in the Supplement).…”

Section: Resultsmentioning

confidence: 99%

“…Fifteen studies had a high risk of bias because the samples were not representative of the target population (eg, special populations) (eTable 3 in the Supplement). Most studies had either low (n = 88) or unclear (n = 5) risk of bias with regard to participant recruitment.…”

Section: Resultsmentioning

confidence: 99%

“…Age groups included neonates (n = 13) 37,39,48,51,55,56,58,61,66,69,77,80,85,86,96 ; infants (n = 24) 15, 36,43,49,54,63,65,72,73,81,83,84,89,97,101,102,111,113,114,116,120,125; and children 2 years or younger (n = 12), 35,42,57,59,71,90,91,94,98,104,105,112 3 years or younger (n = 3), 5 years or younger (n = 2), 41,99 8 years or younger (n = 2), 100,122 10 years or younger (n = 1), and older than 10 years (n = 32). 16,17,38,40,[44][45][46][47]52,53,60,62,64,67,70,[74][75][76]78,82,93,103,[106][107][108][109][110]117,119,121,…”

Section: Study Characteristicsmentioning

confidence: 99%

“…We compared the overall prevalence of C difficile detection according to geographic region: Africa (n = 5), 16,80,88,111,123 North and South America (n = 25), 17,38,43,45,[52][53][54][55][56]62,63,66,67,74,75,87,96,104,109,112,114,117,120,122,124,125 Southeast Asia (n = 3), 47,51,107 Eastern Mediterranean (n = 6), 14,36,40,41,71,85 Europe (n = 40), 15,35,37,39,42,46,49,[57][58][59]61,64,68,72,73,[76][77][78]84,[89]…”

Section: Secondary Outcomesmentioning

confidence: 99%

“…Mode of delivery at time of birth was evaluated in 9 studies (eTable 9 in the Supplement). 36,43,50,72,90,91,95,104,116 Of infants delivered vaginally, 9.1% to 62.5% were colonized with C difficile, and 12% to 43.8% being colonized with toxigenic strains. Among infants with a history of cesarean delivery, 8.4% to 71.1% had C difficile detected, and 7.4% to 13.5% had toxigenic strains detected.…”

Section: Secondary Outcomesmentioning

confidence: 99%

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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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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Study Characteristicsmentioning

confidence: 99%

Section: Secondary Outcomesmentioning

confidence: 99%

Section: Secondary Outcomesmentioning

confidence: 99%

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Prevalence of Detection of Clostridioides difficile Among Asymptomatic Children

et al. 2021

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Identification of Toxin A-Negative, Toxin B-Positive Clostridium difficile by PCR

et al. 1998

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Toxigenic strains of Clostridium difficile have been reported to produce both toxins A and B nearly always, and nontoxigenic strains have been reported to produce neither of these toxins. Recent studies indicate that it is not always true. We established a PCR assay to differentiate toxin A-negative, toxin B-positive (toxin A−, toxin B+) strains from both toxin-positive (toxin A+, toxin B+) strains and both toxin-negative (toxin A−, toxin B−) strains as an alternative to cell culture assay and enzyme-linked immunosorbent assay (ELISA). By using the PCR primer set NK11 and NK9 derived from the repeating sequences of the toxin A gene, a shorter segment (ca. 700 bp) was amplified from toxin A−, toxin B+ strains compared to the size of the segment amplified from toxin A+, toxin B+ strains (ca. 1,200 bp), and no product was amplified from toxin A−, toxin B− strains. We examined a total of 421 C. difficile isolates by PCR. Of these, 48 strains showed a shorter segment by the PCR, were negative by ELISAs for the detection of toxin A, and were positive by cell culture assay. Although the cytotoxin produced by the toxin A−, toxin B+ strains was neutralized by anti-toxin B serum, the appearance of the cytotoxic effects on Vero cell monolayers was distinguishable from that of toxin A+, toxin B+ strains. By immunoblotting, the 44 toxin A−, toxin B+ strains were typed to serogroup F and the remaining four strains were serogroup X. Pulsed-field gel electrophoresis separated the 48 strains into 19 types. The PCR assay for the detection of the repeating sequences combined with PCR amplification of the nonrepeating sequences of either the toxin A or the toxin B gene is indicated to be useful for differentiating toxin A−, toxin B+ strains from toxin A+, toxin B+ and toxin A−, toxin B− strains and will contribute to elucidation of the precise role of toxin A−, toxin B+ strains in intestinal diseases.

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Prevalence of Clostridium difficile Among Healthy Chilean Infants: Evaluation by Commercial Enzyme Immunoassay Versus Standard Cytotoxin Assay

Cited by 2 publications

References 0 publications

Prevalence of Detection of Clostridioides difficile Among Asymptomatic Children

Prevalence of Detection of Clostridioides difficile Among Asymptomatic Children

Identification of Toxin A-Negative, Toxin B-Positive Clostridium difficile by PCR

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