Background: Understanding of Clostridium difficile colonization in healthy children is limited. A case control study of children with acute gastroenteritis (AGE) was done during July 2014 and June 2016 by the Taiwan Pediatric Infectious Diseases Alliance (TPIDA). C. difficile toxin A and B were detected in stool samples from both AGE cases and controls. Methods: Children aged 5 years or less who were hospitalized to member hospitals of the TPIDA due to AGE were recruited for the study. Controls were recruited from hospitalized children or children visiting the outpatient clinics who had no evidence of AGE. PCR was used to detect C. difficile toxin A and B. Comparisons were made between C. difficile positive and negative subjects. Results: Stool samples from 2,646 cases and 1,556 controls were tested for C. difficile toxins. Overall, 8.9% (376/4,202) showed positive of either C. difficile toxins in their stool. There is no significant difference in positive rate between children with and without AGE: 7.9% (209/2,646) in cases and 10.7% (167/1,556) in controls. Among 376 C. difficile toxins-positive subjects,104 (27.7%) also have other pathogens such as norovirus (47), Salmonella (18), or rotavirus (16) detectable in stool. Conclusion: Asymptomatic colonization of C. difficile occurs in children with or without clinical AGE. Diagnosis of C. difficile infection solely based on C. difficile toxin A or B detection in stool is unreliable.
日期:
2017-11
關聯:
International Journal of Antimicrobial Agents. 2017 Nov;50(Suppl. 2):S204.
