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Community-acquired Clostridium difficile infection in Serbian pediatric population

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Abstract

Carriage of Clostridium (C.) difficile in the intestinum of children, as well as its role in the disease (diarrhea) onset, is still controversial. The aim of this study is to investigate the community-acquired Clostridium difficile infection (CA-CDI) in Serbian pediatric population and to describe the basic clinical characteristics and risk factors for CA-CDI occurrence in Serbian pediatric population. The data obtained from 63 Serbian pediatric patients with CA-CDI and from control group of 126 children with community-acquired diarrhea, whose stool specimens were negative for C. difficile and toxins A/B, were mutually compared. In the current work, we found that children with CA-CDI display a significantly less severe disease clinical presentation than children with diarrheas of other origin. Lethal outcome was noted in two cases, but in children with severe underlying diseases (Crohn’s disease and leukemia). By using the multivariate statistical regression model, the following statistically significant risk factors for community-acquired C. difficile-associated diarrhea development were determined: previous application of laxatives (OR = 0.199, CI 0.55–0.79, p = 0.015), general antibiotic use during the previous 2 months (OR = 0.05, CI 0.02–0.17, p < 0.001), and specifically the use of penicillins (OR = 0.112, CI 0.04–0.31, p < 0.0001) and cephalosporins (OR = 0.16, CI 40.06–0.44, p < 0.0001). Antibiotics from the groups of cephalosporins and penicillins were found to be the most important independent risk factors. Laxative application plays a significant role in the community-acquired Clostridium difficile infections in children, with mechanisms that are not completely understood.

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Funding

This study was funded by the Ministry of Education, Science and Technological Development of Serbia [Projects No. 172061].

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Authors and Affiliations

  1. Faculty of Medicine, University of Niš, Zorana Đinđića 81, Niš, 18000, Serbia

    Stojanović Predrag, Kocić Branislava, Stojanović Nikola & Dobrila Stanković-Đorđević

  2. National Reference Laboratory for Anaerobic Infections-Clostridium difficile, Center of Microbiology, Institute for Public Health Nis, Niš, 18000, Serbia

    Stojanović Predrag, Kocić Branislava & Dobrila Stanković-Đorđević

  3. Department of Chemistry, Faculty of Science and Mathematics, University of Niš, Višegradska 33, Niš, 18000, Serbia

    Radulovic Niko

  4. Department of Biology and Ecology, Faculty of Science and Mathematics, University of Niš, Višegradska 33, Niš, 18000, Serbia

    Stojanović-Radić Zorica

Authors
  1. Stojanović Predrag
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  2. Kocić Branislava
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  3. Stojanović Nikola
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  4. Radulovic Niko
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  5. Stojanović-Radić Zorica
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  6. Dobrila Stanković-Đorđević
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Correspondence to Stojanović Predrag.

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The authors declare that they have no conflict of interest.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Informed consent was obtained from parents of all participants included in the study.

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Predrag, S., Branislava, K., Nikola, S. et al. Community-acquired Clostridium difficile infection in Serbian pediatric population. Eur J Clin Microbiol Infect Dis 37, 1061–1069 (2018). https://doi.org/10.1007/s10096-018-3218-6

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  • DOI: https://doi.org/10.1007/s10096-018-3218-6

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