title: Nosocomial outbreak of Clostridium difficile diarrhea in a pediatric service.
abstract: An outbreak of nosocomial diarrhea that occurred in a pediatric orthopedic service between 1 December 1993 and 15 April 1994 is reported. A total of 37 patients (mean age, 9.6 years; range, 2 months-19.3 years) were involved in the outbreak, including six patients with bacteriologically documented Clostridium difficile infection. A multivariate analysis identified lincomycin treatment for at least three days as the only significant risk factor. Stool samples from four asymptomatic patients were also positive for Clostridium difficile and its cytotoxins. Isolates from all patients belonged to serogroup C, were highly resistant to lincomycin, and exhibited the same restriction pattern by pulsed-field gel electrophoresis. The outbreak ended after treatment with lincomycin was discontinued and hygiene control measures were implemented.
authors.affiliation: Laboratoire de Microbiologie, Hôpital Necker-Enfants Malades, Paris, France.
authors.forename: A
authors.initials: A
authors.lastname: Ferroni
authors.forename: J
authors.initials: J
authors.lastname: Merckx
authors.forename: T
authors.initials: T
authors.lastname: Ancelle
authors.forename: B
authors.initials: B
authors.lastname: Pron
authors.forename: E
authors.initials: E
authors.lastname: Abachin
authors.forename: F
authors.initials: F
authors.lastname: Barbut
authors.forename: J
authors.initials: J
authors.lastname: Larzul
authors.forename: P
authors.initials: P
authors.lastname: Rigault
authors.forename: P
authors.initials: P
authors.lastname: Berche
authors.forename: J L
authors.initials: JL
authors.lastname: Gaillard
mesh_terms: D000293:Adolescent; D000328:Adult; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D016022:Case-Control Studies; D002648:Child; D002675:Child, Preschool; D016360:Clostridioides difficile / Q000187:drug effects / Q000235:genetics / Q000302:isolation & purification*; D003428:Cross Infection / Q000188:drug therapy / Q000453:epidemiology / Q000382:microbiology; D004269:DNA, Bacterial / Q000032:analysis / Q000235:genetics; D003967:Diarrhea / Q000188:drug therapy / Q000453:epidemiology* / Q000382:microbiology*; D004196:Disease Outbreaks; D016521:Electrophoresis, Gel, Pulsed-Field; D004761:Enterocolitis, Pseudomembranous / Q000150:complications* / Q000188:drug therapy; D004768:Enterotoxins / Q000032:analysis; D005243:Feces / Q000382:microbiology; D005260:Female; D005500:Follow-Up Studies; D005602:France / Q000453:epidemiology; D005672:Fusidic Acid / Q000627:therapeutic use; D006801:Humans; D007223:Infant; D008034:Lincomycin / Q000627:therapeutic use; D008297:Male; D015999:Multivariate Analysis; D010068:Oxacillin / Q000627:therapeutic use; D010406:Penicillins / Q000627:therapeutic use; D012307:Risk Factors
chemical_list: D000900:Anti-Bacterial Agents; D004269:DNA, Bacterial; D004768:Enterotoxins; D010406:Penicillins; D005672:Fusidic Acid; D008034:Lincomycin; D010068:Oxacillin