title: [Intestinal colonization and nosocomial spread of Clostridium difficile in pediatric cancer patients under long-term hospitalization].
abstract: Clostridium difficile is a major causative agent of antimicrobial-associated diarrhea, and the leading cause of nosocomial diarrhea. We clarified intestinal colonization and nosocomial spread of C. difficile in pediatric cancer patients undergoing antineoplastic therapy during long-term hospitalization. Subjects were 10 children with pediatric malignant diseases admitted from November 2005 to December 2006, aged 5 to 15 years, who received antineoplastic agents. Stool specimens were examined at hospitalization, after each course of treatment with antineoplastic chemotherapy, and when symptoms such as diarrhea or fever occurred. While C. difficile was detected from stool specimens of 8 of 10 children during their hospital stay, 6 of these 8 children were negative for C. difficile on the day of their admission. These results demonstrate that the use of antimicrobial agents and antineoplastic agents lead to overgrowth of C. difficile in intestinal tract of pediatric cancer patients. Five of the 8 children carried toxin A-positive, toxin B-positive C. difficle and 2 were diagnosed with C. difficile-associated diarrhea (CDAD). This demonstrates that CDAD is not a rare infection in pediatric cancer patients. Nine C. difficile isolates from 8 children were analyzed by PCR ribotyping. Two isolates from 2 children were typed into the same type;banding patterns of the remaining 7 isolates from 6 children were unique.
authors.affiliation: Aichi Medical University College of Nursing.
authors.forename: Mayumi
authors.initials: M
authors.lastname: Murabata
authors.forename: Haru
authors.initials: H
authors.lastname: Kato
authors.forename: Hisako
authors.initials: H
authors.lastname: Yano
authors.forename: Masamichi
authors.initials: M
authors.lastname: Ogura
authors.forename: Junko
authors.initials: J
authors.lastname: Shibayama
authors.forename: Yukio
authors.initials: Y
authors.lastname: Wakimoto
authors.forename: Yoshichika
authors.initials: Y
authors.lastname: Arakawa
authors.forename: Masashi
authors.initials: M
authors.lastname: Mizokami
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D016360:Clostridioides difficile / Q000145:classification / Q000235:genetics / Q000302:isolation & purification*; D003428:Cross Infection / Q000453:epidemiology / Q000382:microbiology* / Q000635:transmission; D003967:Diarrhea / Q000453:epidemiology / Q000382:microbiology*; D004761:Enterocolitis, Pseudomembranous / Q000453:epidemiology / Q000382:microbiology* / Q000635:transmission; D005243:Feces / Q000382:microbiology; D005260:Female; D041981:Gastrointestinal Tract / Q000382:microbiology*; D006760:Hospitalization; D006801:Humans; D007902:Length of Stay; D008297:Male; D009369:Neoplasms / Q000382:microbiology*; D021521:Ribotyping