Pediatr Gastroenterol Hepatol Nutr.  2014 Dec;17(4):232-238. 10.5223/pghn.2014.17.4.232.

Clinical Characteristics of Symptomatic Clostridium difficile Infection in Children: Conditions as Infection Risks and Whether Probiotics Is Effective

• Na JY
• Park JM
• Lee KS
• Kang JO
• Oh SH
• Kim YJ

• KMID: 2315497
• DOI: http://doi.org/10.5223/pghn.2014.17.4.232

Abstract

PURPOSE
This study investigated the clinical presentations of symptomatic Clostridium difficile infection (CDI) in children.
METHODS
We reviewed the medical records of 43 children aged <20 years who showed either positive C. difficile culture or C. difficile toxin test results between June 2010 and April 2014.
RESULTS
Of the 43 patients (mean age 6.7 years), 22 were boys. Sixteen patients (37.2%) showed both positive C. difficile culture and toxin test results. Seventeen out of 43 children (39.5%) had preexisting gastrointestinal diseases, and 26 children had other medical conditions that were risk factors for CDI. Twenty-eight children had a history of antibiotic treatment for >3 days, and the most frequently prescribed antibiotic was amoxicillin-clavulanate (35.7%). Twenty-eight patients were diagnosed with CDI despite taking probiotic supplements, most commonly Lactobacillus acidophilus (53.6%). The most common symptom was diarrhea (72.1%) at the time CDI was diagnosed. C. difficile was eradicated in 11 patients (25.6%) after treatment with oral metronidazole for 10-14 days, and in the two patients (4.6%) who required two courses of oral metronidazole. Sixteen patients (37.2%) showed clinical improvement without any treatment.
CONCLUSION
This study showed the various clinical characteristics of CDI in children and that preexisting clinical conditions favored the development of CDI. In addition, CDI was found to occur in a number of patients even after probiotic prophylaxis given in conjunction with antibiotic therapy.

Keyword

Clostridium difficile; Probiotics; Child; Diarrhea

MeSH Terms

Child*
Clostridium difficile*
Diarrhea
Gastrointestinal Diseases
Humans
Lactobacillus acidophilus
Medical Records
Metronidazole
Probiotics*
Risk Factors
Metronidazole

Figure

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  Fig. 1 Age and sex distribution of 43 patients with Clostridium difficile infection.

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  Fig. 2 The proportion of toxin-positive Clostridium difficile in 43 patients.

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