title: A prospective study of Clostridium difficile infection and colonization in pediatric oncology patients.
abstract: BACKGROUND
  Patients with cancer often receive broad spectrum antibiotics in addition to antineoplastic chemotherapy. Both treatments predispose adult oncology patients to infection and colonization with Clostridium difficile, but the role of this pathogen in pediatric oncology patients is poorly defined.
  
  
  METHODS
  A prospective study of 149 fecal samples from symptomatic pediatric oncology patients and 58 samples from asymptomatic patients was performed. Each sample was analyzed for the presence of C. difficile and its toxins A and B.
  
  
  RESULTS
  In 8.7% of the symptomatic samples and 19% of the asymptomatic samples toxigenic C. difficile was found. No association was found between either the use of antibiotics and/or the administration of chemotherapy and the presence of toxigenic C. difficile. Younger children were more likely to be infected or colonized with C. difficile, and there was no evidence of nosocomial transmission of C. difficile within the study population.
  
  
  CONCLUSIONS
  As toxigenic C. difficile may form part of the normal flora in young children, this study indicates that in the absence of a defined outbreak, C. difficile does not appear to be an important pathogen in pediatric oncology patients.
authors.affiliation: Department of Microbiology, Royal Alexandra Hospital for Children, Parramatta, New South Wales, Australia. dburgner@worf.molbiol.ox.ac.uk
authors.forename: D
authors.initials: D
authors.lastname: Burgner
authors.forename: S
authors.initials: S
authors.lastname: Siarakas
authors.forename: G
authors.initials: G
authors.lastname: Eagles
authors.forename: A
authors.initials: A
authors.lastname: McCarthy
authors.forename: R
authors.initials: R
authors.lastname: Bradbury
authors.forename: M
authors.initials: M
authors.lastname: Stevens
mesh_terms: D000293:Adolescent; D000367:Age Factors; D002648:Child; D002675:Child, Preschool; D016360:Clostridioides difficile / Q000302:isolation & purification*; D005243:Feces / Q000382:microbiology; D006801:Humans; D007223:Infant; D009369:Neoplasms / Q000150:complications / Q000382:microbiology*; D011446:Prospective Studies; D012307:Risk Factors