“…The high prevalence of ribotype 017 led the authors to conclude that not only has this C. difficile type gradually replaced other circulating PCR-ribotypes in this hospital, but it could also be associated with a similar spectrum of clinical disease as that caused by tcdA + /tcdB + strains. Ferreira et al (2003) analysed 181 stool samples that were collected over 1 year from children (0-5 years of age) with acute diarrhoea who were admitted to three different hospitals. Samples were also collected from healthy children (without diarrhoea).…”
“…A small study in Brazil attempted to compare strains of C. difficile in hospitalised children with acute diarrhoea with asymptomatic children recruited from day-care centres, but none of the controls were culture positive for C. difficile. Nine out of the ten strains isolated from symptomatic patients were toxigenic: six were tcdA +/tcdB + and three were tcdA−/tcdB + [54].…”
Section: Explanations For High Levels Of Asymptomatic Colonisationmentioning
The clinical significance of the presence of Clostridium difficile in children's faeces remains uncertain using current diagnostic procedures. Clostridium difficile is a relatively common finding in infants with no symptoms of gastrointestinal disease, suggesting it may be an incidental finding and form part of the normal gut micro-flora in this age group. On the other hand, particularly in older children or those with significant co-morbidity, there are examples where C. difficile causes disease and exerts considerable morbidity and even mortality (C. difficile infection, CDI). Between these extremes lie a substantial group of children who have both diarrhoea and C. difficile in their stools but where the nature of the association is not clear: Clostridium difficile associated disease (CDAD). We review the significance of C. difficile in children presenting recently uncovered paediatric data from a large UK epidemiological study that informs some key unanswered questions.
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