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Characteristics and management of children with Clostridioides difficile infection at a tertiary pediatric hospital in China

BACKGROUND: Clostridiodes difficile infection (CDI) is one of the most common causes of antibiotic-associated diarrhea in children. Conventional antibiotics and emerging fecal microbiota transplantation (FMT) are used to treat CDI. METHODS: Children with CDI admitted to the Shanghai Children's...

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Autores principales: Li, Xiaolu, Xiao, Fangfei, Li, Youran, Hu, Hui, Xiao, Yongmei, Xu, Qiao, Li, Dan, Yu, Guangjun, Wang, Yizhong, Zhang, Ting
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Elsevier 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9459065/
https://www.ncbi.nlm.nih.gov/pubmed/35753395
http://dx.doi.org/10.1016/j.bjid.2022.102380
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author Li, Xiaolu
Xiao, Fangfei
Li, Youran
Hu, Hui
Xiao, Yongmei
Xu, Qiao
Li, Dan
Yu, Guangjun
Wang, Yizhong
Zhang, Ting
author_facet Li, Xiaolu
Xiao, Fangfei
Li, Youran
Hu, Hui
Xiao, Yongmei
Xu, Qiao
Li, Dan
Yu, Guangjun
Wang, Yizhong
Zhang, Ting
author_sort Li, Xiaolu
collection PubMed
description BACKGROUND: Clostridiodes difficile infection (CDI) is one of the most common causes of antibiotic-associated diarrhea in children. Conventional antibiotics and emerging fecal microbiota transplantation (FMT) are used to treat CDI. METHODS: Children with CDI admitted to the Shanghai Children's Hospital, from September 2014 to September 2020, were retrospectively included to this observational study. Pediatric patients were assigned as initial CDI and recurrent CDI (RCDI), and symptoms, comorbidities, imaging findings, laboratory tests, and treatments were systematically recorded and analyzed. RESULTS: Of 109 pediatric patients with CDI, 58 were boys (53.2%), and the median age was 5 years (range, 2-9 years). The main clinical symptoms of CDI children were diarrhea (109/109, 100%), hematochezia (55/109, 50.46%), abdominal pain (40/109, 36.70%); fever, pseudomembrane, vomit, and bloating were observed in 39 (35.78%), 33 (30.28%), and 24 (22.02%) patients, respectively. For the primary therapy with conventional antibiotics, 68 patients received metronidazole, and 41 patients received vancomycin. RCDI occurred in 48.53% (33/68) of those initially treated with metronidazole compared with 46.33% (19/41) of those initially treated with vancomycin (p=0.825). The total resolution rate of FMT for RCDI children was significantly higher than with vancomycin treatment (28/29, 96.55% vs 11/23, 47.83%, p < 0.001). There were no serious adverse events (SAEs) reported after two months of FMT. CONCLUSIONS: The major manifestations of children with CDI were diarrhea, hematochezia, and abdominal pain. The cure rate of FMT for pediatric RCDI is superior to vancomycin treatment.
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spelling pubmed-94590652022-09-10 Characteristics and management of children with Clostridioides difficile infection at a tertiary pediatric hospital in China Li, Xiaolu Xiao, Fangfei Li, Youran Hu, Hui Xiao, Yongmei Xu, Qiao Li, Dan Yu, Guangjun Wang, Yizhong Zhang, Ting Braz J Infect Dis Original Article BACKGROUND: Clostridiodes difficile infection (CDI) is one of the most common causes of antibiotic-associated diarrhea in children. Conventional antibiotics and emerging fecal microbiota transplantation (FMT) are used to treat CDI. METHODS: Children with CDI admitted to the Shanghai Children's Hospital, from September 2014 to September 2020, were retrospectively included to this observational study. Pediatric patients were assigned as initial CDI and recurrent CDI (RCDI), and symptoms, comorbidities, imaging findings, laboratory tests, and treatments were systematically recorded and analyzed. RESULTS: Of 109 pediatric patients with CDI, 58 were boys (53.2%), and the median age was 5 years (range, 2-9 years). The main clinical symptoms of CDI children were diarrhea (109/109, 100%), hematochezia (55/109, 50.46%), abdominal pain (40/109, 36.70%); fever, pseudomembrane, vomit, and bloating were observed in 39 (35.78%), 33 (30.28%), and 24 (22.02%) patients, respectively. For the primary therapy with conventional antibiotics, 68 patients received metronidazole, and 41 patients received vancomycin. RCDI occurred in 48.53% (33/68) of those initially treated with metronidazole compared with 46.33% (19/41) of those initially treated with vancomycin (p=0.825). The total resolution rate of FMT for RCDI children was significantly higher than with vancomycin treatment (28/29, 96.55% vs 11/23, 47.83%, p < 0.001). There were no serious adverse events (SAEs) reported after two months of FMT. CONCLUSIONS: The major manifestations of children with CDI were diarrhea, hematochezia, and abdominal pain. The cure rate of FMT for pediatric RCDI is superior to vancomycin treatment. Elsevier 2022-06-23 /pmc/articles/PMC9459065/ /pubmed/35753395 http://dx.doi.org/10.1016/j.bjid.2022.102380 Text en © 2022 Sociedade Brasileira de Infectologia. Published by Elsevier España, S.L.U. https://creativecommons.org/licenses/by-nc-nd/4.0/This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).
spellingShingle Original Article
Li, Xiaolu
Xiao, Fangfei
Li, Youran
Hu, Hui
Xiao, Yongmei
Xu, Qiao
Li, Dan
Yu, Guangjun
Wang, Yizhong
Zhang, Ting
Characteristics and management of children with Clostridioides difficile infection at a tertiary pediatric hospital in China
title Characteristics and management of children with Clostridioides difficile infection at a tertiary pediatric hospital in China
title_full Characteristics and management of children with Clostridioides difficile infection at a tertiary pediatric hospital in China
title_fullStr Characteristics and management of children with Clostridioides difficile infection at a tertiary pediatric hospital in China
title_full_unstemmed Characteristics and management of children with Clostridioides difficile infection at a tertiary pediatric hospital in China
title_short Characteristics and management of children with Clostridioides difficile infection at a tertiary pediatric hospital in China
title_sort characteristics and management of children with clostridioides difficile infection at a tertiary pediatric hospital in china
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9459065/
https://www.ncbi.nlm.nih.gov/pubmed/35753395
http://dx.doi.org/10.1016/j.bjid.2022.102380
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