title: [Clostridium difficile toxin A and other enteropathogens in stool specimens of children hospitalized due to acute diarrhoea].
abstract: A total of 74 fresh stool specimens obtained from children with acute diarrhoea (43) and without diarrhoea (31) were examined simultaneously for bacteria pathogens (culture methods) and for Clostridium difficile toxin A (Oxoid Toxin A Kits) and enteric viruses (only diarrhoeal samples) (Slidex Rota-Adeno Kits; bioMçrieux). One (49%) or dual with C. difficile (23%) enteric pathogens associated with community-acquired diarrhoea (58% bacteria and 14% viruses) in 31 (72%) children were recognized. Clostridium difficile associated diarrhoea (CDAD) (18,6%) and Salmonella enterica subsp. enterica serovar Enteritidis (16,3%) the most commonly were observed. Children were considered to have CDAD if they met special criteria such as the positive test for C. difficile toxin A, the presence of diarrhoea for at least 2 days and no other documented enteric pathogens. It was be found that antibiotic usage in the previous 3 weeks as a main risk factor for CDAD not be frequent (only 2/8 CDAD). The frequency of C. difficile toxin A detection in the diarrhoeal stool specimens from children treated or not treated with antibiotics was comparable (p>0,05); this same observed when stool specimens from children without diarrhoea were tested. The frequency of toxin A detection in stool specimens from children with acute diarrhoea (41,9%) and without diarrhoea (54,8%) was comparable (p>0,05) also. In conclusion, we recommended detection of toxin A by C. difficile toxin A Test as the rapid screening in diarrhoeal stool specimens only because the high predictive value of a negative test and the high sensitivity for CDAD with special criteria were found.
authors.affiliation: Klinika Obserwacyjno-Zakalukzna Dzieci Akademii Medycznej w Białymstoku.
authors.forename: Dorota
authors.initials: D
authors.lastname: Rozkiewicz
authors.forename: Maria Lucyna
authors.initials: ML
authors.lastname: Zaremba
authors.forename: Krzysztof
authors.initials: K
authors.lastname: Fiedoruk
authors.forename: Tamara
authors.initials: T
authors.lastname: Daniluk
authors.forename: Małgorzata
authors.initials: M
authors.lastname: Sciepuk
authors.forename: Bozena
authors.initials: B
authors.lastname: Kurzatkowska
authors.forename: Artur
authors.initials: A
authors.lastname: Sulik
authors.forename: Elbieta
authors.initials: E
authors.lastname: Ołdak
mesh_terms: D000208:Acute Disease; D000293:Adolescent; D000900:Anti-Bacterial Agents / Q000009:adverse effects; D001427:Bacterial Toxins / Q000302:isolation & purification*; D002648:Child; D002675:Child, Preschool; D016360:Clostridioides difficile / Q000302:isolation & purification; D003967:Diarrhea / Q000188:drug therapy / Q000382:microbiology*; D004768:Enterotoxins / Q000302:isolation & purification*; D005243:Feces / Q000382:microbiology*; D005260:Female; D006801:Humans; D007124:Immunoenzyme Techniques / Q000379:methods; D007223:Infant; D008297:Male; D011933:Reagent Kits, Diagnostic; D019779:Salmonella enterica / Q000276:immunology; D012680:Sensitivity and Specificity
chemical_list: D000900:Anti-Bacterial Agents; D001427:Bacterial Toxins; D004768:Enterotoxins; D011933:Reagent Kits, Diagnostic; C041348:tcdA protein, Clostridium difficile