Clostridium difficile infection in Polish pediatric outpatients with inflammatory bowel diseaseReport as inadecuate




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European Journal of Clinical Microbiology and Infectious Diseases

, Volume 29, Issue 10, pp 1265–1270

First Online: 26 June 2010Received: 11 March 2010Accepted: 29 May 2010

Abstract

The prevalence of Clostridium difficile infection CDI in pediatric patients with inflammatory bowel disease IBD is still not sufficiently recognized. We assessed the prevalence of CDI and recurrences in outpatients with IBD. In addition, the influence of IBD therapy on CDI and antimicrobial susceptibility of the potentially causative C. difficile strains was assessed. This was a prospective, single-center, observational study. All specimens were obtained between January 2005 and January 2007 from the IBD outpatient service and screened for C. difficile and its toxins. C. difficile isolates were genotyped by PCR ribotyping. Diagnosis of Crohn’s disease CD and ulcerative colitis UC was based on Porto criteria. Severity of disease was assessed using the Hyams scale for Crohn’s disease and the Truelove–Witts scale for ulcerative colitis. One hundred and forty-three fecal samples from 58 pediatric IBD patients 21 with Crohn’s disease and 37 with ulcerative colitis were screened. The risk of C. difficile infection was 60% and was independent of disease type CD or UC χ2 = 2.5821, df = 3, p = 0.4606. About 17% of pediatric IBD patients experienced a recurrence of CDI. All C. difficile strains were susceptible to metronidazole, vancomycin and rifampin. A high prevalence of C. difficile infection and recurrences in pediatric outpatients with IBD was observed, independent of disease type. There was no significant correlation between C. difficile infection and IBD therapy. PCR ribotyping revealed C. difficile re-infection and relapses during episodes of IBD in pediatric outpatients.

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Author: D. Wultańska - A. Banaszkiewicz - A. Radzikowski - P. Obuch-Woszczatyński - G. Młynarczyk - J. S. Brazier - H. Pituch -

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