title: Clinical Characteristics of Symptomatic Clostridium difficile Infection in Children: Conditions as Infection Risks and Whether Probiotics Is Effective.
abstract: OBJECTIVE
  This study investigated the clinical presentations of symptomatic Clostridium difficile infection (CDI) in children.
  
  
  METHODS
  We reviewed the medical records of 43 children aged <20 years who showed either positive C. difficile culture or C. difficile toxin test results between June 2010 and April 2014.
  
  
  RESULTS
  Of the 43 patients (mean age 6.7 years), 22 were boys. Sixteen patients (37.2%) showed both positive C. difficile culture and toxin test results. Seventeen out of 43 children (39.5%) had preexisting gastrointestinal diseases, and 26 children had other medical conditions that were risk factors for CDI. Twenty-eight children had a history of antibiotic treatment for >3 days, and the most frequently prescribed antibiotic was amoxicillin-clavulanate (35.7%). Twenty-eight patients were diagnosed with CDI despite taking probiotic supplements, most commonly Lactobacillus acidophilus (53.6%). The most common symptom was diarrhea (72.1%) at the time CDI was diagnosed. C. difficile was eradicated in 11 patients (25.6%) after treatment with oral metronidazole for 10-14 days, and in the two patients (4.6%) who required two courses of oral metronidazole. Sixteen patients (37.2%) showed clinical improvement without any treatment.
  
  
  CONCLUSIONS
  This study showed the various clinical characteristics of CDI in children and that preexisting clinical conditions favored the development of CDI. In addition, CDI was found to occur in a number of patients even after probiotic prophylaxis given in conjunction with antibiotic therapy.
authors.affiliation: Department of Pediatrics, Hanyang University College of Medicine, Seoul, Korea.
authors.forename: Jae Yoon
authors.initials: JY
authors.lastname: Na
authors.affiliation: Department of Pediatrics, Hanyang University College of Medicine, Seoul, Korea.
authors.forename: Jong Mo
authors.initials: JM
authors.lastname: Park
authors.affiliation: Department of Pediatrics, Hanyang University College of Medicine, Seoul, Korea.
authors.forename: Kyung Suk
authors.initials: KS
authors.lastname: Lee
authors.affiliation: Department of Laboratory Medicine, Hanyang University College of Medicine, Seoul, Korea.
authors.forename: Jung Oak
authors.initials: JO
authors.lastname: Kang
authors.affiliation: Department of Pediatrics, Hanyang University College of Medicine, Seoul, Korea.
authors.forename: Sung Hee
authors.initials: SH
authors.lastname: Oh
authors.affiliation: Department of Pediatrics, Hanyang University College of Medicine, Seoul, Korea.
authors.forename: Yong Joo
authors.initials: YJ
authors.lastname: Kim
keywords: Child; Clostridium difficile; Diarrhea; Probiotics