Clostridioides difficile infection in infants: a case report and literature review

BACKGROUND

Clostridioides difficile (C. difficile) is the major pathogen causing antibiotic-associated diarrhea. There are a variety of symptoms associated with C. difficile infection (CDI) in adults, including self-limiting diarrhea, pseudomembranous colitis, toxic megacolon, septic shock, and even death from the infection. However, the infant's intestine appears to be completely resistant to the effects of C. difficile toxins A and B with rare development of clinical symptoms.

CASE PRESENTATION

In this study, we reported a 1-month-old girl with CDI who was born with neonatal hypoglycemia and necrotizing enterocolitis. Her symptom of diarrhea occurred after extensive use of broad-spectrum antibiotics during hospitalization and was accompanied by elevated white blood cell, platelet, and C-reactive protein levels, and repeated routine stool examinations were abnormal. She was recovered by norvancomycin (an analogue of vancomycin) and probiotic treatment. The results of 16 S rRNA gene sequencing also demonstrated the recovery of intestinal microbiota with the enrichment of Firmicutes and Lactobacillus.

CONCLUSIONS

Based on the literature review and this case report, clinicians should also pay attention to diarrhea caused by C. difficile in infants and young children. More strong evidence is needed to explain the true prevalence of CDI in this population and to better understand the C. difficile-associated diarrhea in infants.

Antimicrobial Activity of Tannic Acid In Vitro and Its Protective Effect on Mice against Clostridioides difficile

Clostridioides difficile infection (CDI), recurrently reported as an urgent threat owing to its increased prevalence and mortality, has attracted significant attention. As the use of antibiotics to treat CDI has many limitations, such as high recurrence rate, the need to actively seek and develop other drugs that can effectively treat CDI with fewer side effects has become a key issue in CDI prevention and treatment. This study aimed to evaluate the inhibitory effect of Galla chinensis (GC) and its main component, tannic acid (TA), against C. difficile in vitro and its therapeutic effect on CDI in vivo. When GC and TA concentrations were 250 and 64 mg/L, respectively, the cumulative antibacterial rate against C. difficile reached 100%. The sub-MIC of TA significantly inhibited C. difficile sporulation, toxin production, and biofilm formation in vitro. Compared with the CDI control group, TA-treated mice lost less weight and presented a significantly improved survival rate. TA significantly reduced the number of spores in feces, decreased serum TcdA level, and increased serum interleukin 10 (IL-10). Based on the inhibitory effect of TA on C. difficile in vitro and its therapeutic effect on the CDI mouse model, we consider TA as a potentially effective drug for treating CDI. IMPORTANCE Clostridioides difficile is one of the major pathogens to cause antibiotic-associated diarrhea. Although antibiotic treatment is still the most commonly used and effective treatment for CDI, the destruction of indigenous intestinal microbiota by antibiotics is the main reason for the high CDI recurrence rate of about 20%, which is increasing every year. Moreover, the growing problem of drug resistance has also become a major hidden danger in antibiotic treatment. GC has been used to treat diarrhea in traditional Chinese medicine. In the present study, we evaluated the inhibitory effect of TA, the main component of GC, on dissemination and pathogenic physiological functions of C. difficile in vitro, as well as its therapeutic efficacy in a CDI model. Overall, TA is considered to be a potentially effective drug for CDI treatment.

Effects of a fully enclosed hollow-fiber centrifugal ultrafiltration technique for laboratory biosafety improvement

Laboratory biosafety has become a core focus in biological analysis, owing to the frequent occurrence of laboratory-acquired infections caused by the leakage of pathogenic microorganisms. For this purpose, the authors developed a safe pretreatment device combining a sealing technique with a direct injection technique. In this study, several bacteria and viruses were used to validate the filtration effect of the invention. Data show that the new device can completely filter bacteria and that the filtration rates for hepatitis B virus and hepatitis C virus reached 94% and 96%, respectively. The results show that the new preparation device can effectively block these pathogens and can improve biological safety and provide powerful protection for technicians.

[Morphological observation on hypopus of Lepidoglyphus destructor by optical microscope]

Objective To observe the external morphology of Lepidoglyphus destructor hypopus under an optical microscope. Methods The samples were collected in a store of Chinese medicinal herbs in Huainan City in September, 2016, the L. destructor and the hypopus were isolated, and then made of slide specimens. The slide samples were prepared and observed under an optical microscope. Results The L. destructor hypopus and protonymph were found. The inactive hypopus was oval in shape, the feet were not welldeveloped, there was a distinct transverse seam on its back, and there were 2 pairs of genital sensory organs. Conclusion The optical microscopy shows the morphological characteristics of L. destructor hypopus, which can provide the basis for the biological classification and the prevention.

[Gohieria fuscus breeding heavily in grand dust flour of a flourmill]

Objective To investigate the breeding quantity and average breeding density of Gohieria fuscus in the grand dust flour of a flourmill and explore the prevention and control measures. Methods A certain amount of grand dust flour was collected from a flourmill, and it was sieved. The powder was placed into the glass pan, and the mites were sought out under an optical microscope and made of specimens. The mites were identified on the basis of literature. Results In this survey, 400 g samples were collected from 4 habitats. The average breeding density of mites was 3 516/g. The mite was identified as Gohieria fuscus. ConclusionsGohieria fuscus is one of the widely distributed stored mites. It impacts the stored food and reduces the quality of food. In addition, the mite affects human health. Therefore, the preventive measures should be taken.

HOLON/CADSE: integrating open software standards and formal methods to generate guideline-based decision support agents

This paper describes the efforts of a consortium that is trying to develop and validate formal methods and a meta-environment for authoring, checking, and maintaining a large repository of machine executable practice guidelines. The goal is to integrate and extend a number of open software standards so that guidelines in the meta-environment become a resource that any vendor can plug their applications into and run in their proprietary environment provided they conform to the interface standards.