Paediatria Croatica, Vol. 61 No. 2, 2017.
Original scientific paper
https://doi.org/10.13112/PC.2017.10
Clostridium diffi cile infection in children: characteristics and treatment – a single-center study from Romania
Gabriela Lesanu
; Grigore Alexandrescu Emergency
Maria Vlad Raluca
Abstract
The incidence of Clostridium diffi cile infection (CDI) in children is progressively increasing. The study evaluated the characteristics
and antibacterial treatment of CDI at a Romanian pediatric gastroenterology department. We performed a retrospective study to
analyze cases diagnosed with CDI, identifi ed through immunoassays for Clostridium diffi cile toxins in stools, between January 1,
2005 and December 31, 2015. Eighty-nine episodes of CDI were diagnosed in 73 patients. We noticed an increasing incidence reaching
maximum in 2014 with 6.9 cases/1000 patients. Almost 40% of patients had community-acquired CDI. The most frequently
associated comorbidities were infl ammatory bowel disease and cow’s milk allergy. There was a small percentage of recurrent episodes
(24.2%). Metronidazole was administered as fi rst-line treatment in 49.2% of mild/moderate cases and proved eff ective in 79.4%
of these. More than 70% of all patients in which metronidazole was not effi cient had comorbidities, compared to 22.2% of patients
where metronidazole was effi cacious. The alternative was vancomycin which cured the disease in all cases. In severe forms, a combination
of intravenous metronidazole and oral vancomycin was the effi cient solution. Oral vancomycin was the effi cacious treatment
for the fi rst recurrence. We report an increasing incidence of CDI in Romanian children. The failure rate for metronidazole
treatment was low, thus metronidazole may be safely recommended for the fi rst episode of mild/moderate CDI. Vancomycin proved
eff ective in all cases, regardless of the fi rst episode or recurrence, and may be used effi ciently as fi rst-line treatment.
Keywords
Clostridium diffi cile; antibacterial treatment; children
Hrčak ID:
201054
URI
Publication date:
22.6.2017.
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