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http://dx.doi.org/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, Jae Yoon (Department of Pediatrics, Hanyang University College of Medicine)
Park, Jong Mo (Department of Pediatrics, Hanyang University College of Medicine)
Lee, Kyung Suk (Department of Pediatrics, Hanyang University College of Medicine)
Kang, Jung Oak (Department of Laboratory Medicine, Hanyang University College of Medicine)
Oh, Sung Hee (Department of Pediatrics, Hanyang University College of Medicine)
Kim, Yong Joo (Department of Pediatrics, Hanyang University College of Medicine)
Publication Information
Pediatric Gastroenterology, Hepatology & Nutrition / v.17, no.4, 2014 , pp. 232-238 More about this Journal
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.
Keywords
Clostridium difficile; Probiotics; Child; Diarrhea;
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