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KMID : 0816120140170040232
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Korean Journal of Pediatric Gastroenterolology and Nutrition
2014 Volume.17 No. 4 p.232 ~ p.238
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Clinical Characteristics of Symptomatic Clostridium difficile Infection in Children: Conditions as Infection Risks and Whether Probiotics Is Effective
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Na Jae-Yoon
Park Jong-Mo
Lee Kyung-Suk
Kang Jung-Oak
Oh Sung-Hee
Kim Yong-Joo
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Abstract
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Purpose: 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. difficileculture 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 dis-eases, 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. difficilewas 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 with-out any treatment.
Conclusion: 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.
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KEYWORD
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Clostridium difficile, Probiotics, Child, Diarrhea
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