1887

Abstract

strains were detected in 14 of 210 (6.7 %) faecal samples from children in Rio de Janeiro, Brazil, by cultivating faeces on cycloserine/cefoxitin/fructose agar after alcohol-shock. Two main groups of children were studied: inpatients ( = 96) and outpatients ( = 114). The inpatient group consisted of children on antibiotics or immunosuppressors who presented with diarrhoea and other children who did not present with diarrhoea and were not under an antibiotic or chemotherapeutic regimen. Among the outpatients, two groups were examined: namely, a group that comprised children who presented with diarrhoea and were occasionally under an antibiotic regimen and another group that comprised patients who were not taking antibiotics. After cytotoxic assay, toxigenic ( tox) strains were detected in 4.2 % of inpatients and 3.5 % of outpatients. Exclusion of other infectious causes of diarrhoea indicated a typical case of -associated paediatric diarrhoea in the community. Among tox isolates, no variations were detected by PCR for toxin A that employed primers NK9 and NKVO11. No resistance was found to metronidazole or vancomycin among strains that were isolated from children who presented with diarrhoea, but the MIC and MIC values for clindamycin were 6–8 and 16 μg ml, respectively. Resistance to clindamycin seems to be more disseminated in strains from outpatients than in those from inpatients ( < 0.05). In conclusion, these data suggest that investigation for infection should be taken into account in paediatric diarrhoea in both inpatients and outpatients in developing countries.

Loading

Article metrics loading...

/content/journal/jmm/10.1099/jmm.0.05308-0
2003-12-01
2024-05-01
Loading full text...

Full text loading...

/deliver/fulltext/jmm/52/12/JM521209.html?itemId=/content/journal/jmm/10.1099/jmm.0.05308-0&mimeType=html&fmt=ahah

References

  1. Anand A, Glatt A. E. 1993; Clostridium difficile infection associated with antineoplastic chemotherapy: a review. Clin Infect Dis 17:109–113 [CrossRef]
    [Google Scholar]
  2. Antunes E. N. F, Ferreira E. O, Vallim D. C, Paula G. R, Seldin L, Sabrá A, Ferreira M. C. S, Domingues R. M. C. P. 2002; Pattern III non-toxigenic Bacteroides fragilis (NTBF) strains in Brazil. Anaerobe 8:17–22 [CrossRef]
    [Google Scholar]
  3. Barbut F, Decré D, Burghoffer B. 8 other authors 1999; Antimicrobial susceptibilities and serogroups of clinical strains of Clostridium difficile isolated in France in 1991 and 1997. Antimicrob Agents Chemother 43:2607–2611
    [Google Scholar]
  4. Bern C, Martines J, de Zoysa I, Glass R. I. 1992; The magnitude of the global problem of diarrhoeal disease: a ten-year update. Bull World Health Organ 70:705–714
    [Google Scholar]
  5. Bolmström A. 1993; Susceptibility testing of anaerobes with Etest. Clin Infect Dis 16:Suppl. 4S367–S370 [CrossRef]
    [Google Scholar]
  6. Brazier J. S. 2001; Typing of Clostridium difficile . Clin Microbiol Infect 7:428–431 [CrossRef]
    [Google Scholar]
  7. Brazier J. S, Borriello S. P. 2000; Microbiology, epidemiology and diagnosis of Clostridium difficile infection. Curr Top Microbiol Immunol 250:1–33
    [Google Scholar]
  8. Citron D. M, Ostovari M. I, Karlsson A, Goldstein E. J. 1991; Evaluation of the E test for susceptibility testing of anaerobic bacteria. J Clin Microbiol 29:2197–2203
    [Google Scholar]
  9. Hopkins M. J, MacFarlane G. T. 2002; Changes in predominant bacterial populations in human faeces with age and with Clostridium difficile infection. J Med Microbiol 51:448–454
    [Google Scholar]
  10. Kader H. A, Piccoli D. A, Jaward A. F, McGowan K. L, Maller E. S. 1998; Single toxin detection is inadequate to diagnose Clostridium difficile diarrhea in pediatric patients. Gastroenterology 115:1329–1334 [CrossRef]
    [Google Scholar]
  11. Kato H, Kato N, Katow S, Maegawa T, Nakamura S, Lyerly D. M. 1999; Deletions in the repeating sequences of the toxin A gene of toxin A-negative, toxin B-positive Clostridium difficile strains. FEMS Microbiol Lett 175:197–203 [CrossRef]
    [Google Scholar]
  12. McFarland L. V, Brandmarker S. A, Guandalini S. 2000; Pediatric Clostridium difficile : a phantom menace or clinical reality?. J Pediatr Gastroenterol Nutr 31:220–231 [CrossRef]
    [Google Scholar]
  13. McGowan K. L, Kader H. A. 1999; Clostridium difficile infection in children. Clin Microbiol Newsl 21:49–53 [CrossRef]
    [Google Scholar]
  14. NCCLS 1997 Methods for Antimicrobial Susceptibility Testing of Anaerobic Bacteria , 4th edn. Approved. Standard M11-A4 Villanova, PA: National Committee for Clinical Laboratory Standards;
    [Google Scholar]
  15. Pelaez T, Martinez-Sanchez L, Alcala L, Munoz P, Garcia-Lechuz J. M, Rodriguez-Creixems M, Bouza E. 1998; Metronidazole resistance in Clostridium difficile : a new emerging problem?. In Program and Abstracts of the 38th Interscience Conference on Antimicrobial Agents and Chemotherapy p p– 219 abstract no. E-173: Washington, DC: American Society for Microbiology;
    [Google Scholar]
  16. Pitcher D. G, Saunders N. A, Owen R. J. 1989; Rapid extraction of bacterial genomic DNA with guanidium thiocyanate. Lett Appl Microbiol 8:151–156 [CrossRef]
    [Google Scholar]
  17. Price E. M, Wright V. M, Walker-Smith J. A, Tabaqchali S. 1988; Clostridium difficile and acute enterocolitis. Arch Dis Child 63:543–545 [CrossRef]
    [Google Scholar]
  18. Rietra P. J. G. M, Slaterus K. W, Zanen H. C, Meuwissen S. G. M. 1978; Clostridial toxin in faeces of healthy infants. Lancet ii319
    [Google Scholar]
  19. Riley T. V, Wetherall F, Bowman J, Mogyorosy J, Golledge C. L. 1991; Diarrhoeal disease due to Clostridium difficile in general practice. Pathology 23:346–349 [CrossRef]
    [Google Scholar]
  20. Sumannen P, Baron E. J. 1993 Wadsworth Anaerobic Bacteriology Manual , 5th edn. Belmont, CA: Wadsworth;
    [Google Scholar]
  21. Wust J, Hardegger U. 1992; Comparison of the E test and a reference agar dilution method for susceptibility testing of anaerobic bacteria. Eur J Clin Microbiol Infect Dis 11:1169–1173 [CrossRef]
    [Google Scholar]
http://instance.metastore.ingenta.com/content/journal/jmm/10.1099/jmm.0.05308-0
Loading
/content/journal/jmm/10.1099/jmm.0.05308-0
Loading

Data & Media loading...

This is a required field
Please enter a valid email address
Approval was a Success
Invalid data
An Error Occurred
Approval was partially successful, following selected items could not be processed due to error