title: Limited clinical utility of Clostridium difficile toxin testing in infants in a pediatric hospital.
abstract: Previous studies have shown high rates of asymptomatic carriage of toxin-producing Clostridium difficile in infants. We performed a retrospective case control study comparing infants younger than 1 year old with diarrhea and C. difficile toxin (CDT) in the stool, to age-matched controls with diarrhea lacking CDT in the stool. We found no difference in clinical characteristics including fever, vomiting, or hematochezia. Treatment with metronidazole had no significant effect on the clinical outcome. Alternative etiologies for diarrhea (most commonly viral) were found in more than 50% of patients in both groups. We recommend that other causes of diarrhea be considered before C. difficile colitis in this age group.
authors.affiliation: Department of Laboratory Medicine and Pathobiology, The University of Toronto, Toronto, Ontario M5G IL5, Canada.
authors.forename: Patrick
authors.initials: P
authors.lastname: Tang
authors.forename: Margaret
authors.initials: M
authors.lastname: Roscoe
authors.forename: Susan E
authors.initials: SE
authors.lastname: Richardson
mesh_terms: D000890:Anti-Infective Agents / Q000627:therapeutic use; D001427:Bacterial Toxins / Q000032:analysis*; D016022:Case-Control Studies; D016360:Clostridioides difficile / Q000254:growth & development*; D003015:Clostridium Infections / Q000175:diagnosis*; D003968:Diarrhea, Infantile / Q000175:diagnosis / Q000188:drug therapy / Q000382:microbiology*; D004768:Enterotoxins / Q000032:analysis*; D005243:Feces / Q000382:microbiology; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D008795:Metronidazole / Q000627:therapeutic use; D012189:Retrospective Studies
chemical_list: D000890:Anti-Infective Agents; D001427:Bacterial Toxins; D004768:Enterotoxins; C041348:tcdA protein, Clostridium difficile; D008795:Metronidazole