Abu Faddan NH, Aly SA, Abou Faddan HH. Nosocomial Clostridium difficile-associated diarrhoea in Assiut University Children's Hospital, Egypt.
Paediatr Int Child Health 2016;
36:39-44. [PMID:
25496416 DOI:
10.1179/2046905514y.0000000167]
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Abstract
BACKGROUND
There are no large epidemiological studies of Clostridium difficile-associated disease (CDAD) in hospitalised children.
AIM
To describe the frequency, demography, clinical features and outcome of nosocomial CDAD in children admitted to Assiut University Children's Hospital, Egypt.
PATIENTS AND METHODS
In this descriptive cross-sectional study, 72 children developed nosocomial diarrhoea between April 2010 and March 2011. A medical history, clinical assessment and culture for Clostridium difficile and direct toxin detection from stool samples by enzyme immuno-assay were undertaken in all patients.
RESULTS
CDAD was diagnosed in 17 (23·6%) patients. Those aged ≤12 months were the most commonly affected (eight, 47%). The main cause of admission was respiratory disorders (eight, 47% of cases), followed by surgical problems (three, 17·7%). Ten patients (58·8%) had severe symptoms. There were no statistically significant differences between any of the demographic or laboratory data for children with CDAD and children with other causes of nosocomial diarrhoea. None of the patients developed complications. Seven children with CDAD (41·2%) had recurrence.
CONCLUSION
CDAD is an important cause of nosocomial diarrhoea in children in Assiut University Children's Hospital. Established guidelines should be followed in all hospitals to minimise exposure to the pathogen. Physicians can do much to reduce the risk of a severe outcome in children by early identification and rapid management. Further research should be undertaken to identify the risk factors for recurrence.
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