ArticleClinical microbiology and infection : the official publication of the European Society of Clinical Microbiology and Infectious Diseases2022
Clostridioides difficile colonization among very young children in resource-limited settings.
Article in Clinical microbiology and infection : the official publication of the European Society of Clinical Microbiology and Infectious Diseases, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers.
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7 citing papers in PubMed, 16 citations in OpenAlex.
- Understanding the influence of the microbiome on childhood infections.Expert review of anti-infective therapy · 2024Review
- Enhancing enteric pathogen detection: implementation and impact of multiplex PCR for improved diagnosis and surveillance.BMC infectious diseases · 2024Article
- Development and evaluation of a rapid visual loop-mediated isothermal amplification assay for thePeerJ · 2024Article
- Clostridioides difficile Infection in Children: Recent Updates on Epidemiology, Diagnosis, Therapy.Pediatrics · 2023Review
- Article
- The Impact of a Positive BiofireDiagnostics (Basel, Switzerland) · 2023Article
- The Hospital Environment as a Potential Source forInternational journal of environmental research and public health · 2023Article
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Authors and funding
6 authors at 2 institutions in 2 countries.
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Abstract
objectivesTo describe the epidemiology and risk factors for Clostridioides difficile (C. difficile) colonization among young children in eight low-resource settings.
methodsWe tested 41 354 monthly non-diarrhoeal and diarrhoeal stools for C. difficile toxin genes (TcdA and TcdB) using quantitative PCR (qPCR) in 1715 children from birth to age two years in a multisite birth cohort study. We estimated the prevalence, cumulative incidence, and seasonality of C. difficile colonization and investigated the associations of C. difficile detection with risk factors of infection, markers of enteropathy, and growth.
resultsThe prevalence of C. difficile detection was lower in diarrhoeal (2.2%; n = 151/6731) compared to non-diarrhoeal stools (6.1%; n = 2106/34 623). By 24 months of age, the cumulative incidence of C. difficile varied widely by site, with 17.9% (n = 44; Pakistan) to 76.3% (n = 148; Peru) of children having at least one positive stool. Only Bangladesh and Pakistan had seasonal differences in C. difficile detection. Female sex (adjusted risk ratio (aRR): 1.18; 95% CI: 1.02-1.35), cephalosporin use in the past 15 days (aRR: 1.73; 95% CI: 1.39-2.16), and treated water (aRR: 1.24; 95% CI: 1.02-1.50) were risk factors for C. difficile positivity. The presence of C. difficile was significantly associated with elevated faecal myeloperoxidase, neopterin, and α-1-antitrypsin, but no associations were found between C. difficile and child growth at 24 months of age. DISCUSSION: C. difficile colonization among children ages 0-2 years was variable across low-resource settings. Significant elevation of intestinal inflammation and barrier disruption markers associated with C. difficile detection suggests a subclinical impact of colonization.
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