The role of Clostridium difficile in childhood nosocomial diarrhea.

The role of Clostridium difficile was investigated in 100 children with nosocomial diarrhea. An etiologic agent was identified in 69 cases, 8 of whom had dual infection. C. difficile-associated diarrhea (Cdad) was defined in 16 children (16%). The mean age of the patients with Cdad was 5.4 y (range 2 months to 13 y) and the male:female ratio was 1.2. All cases with Cdad were on antibiotic therapy. Cdad occurred more frequently in the cases given combined antibiotic treatment than in those given single antibiotic treatment (p < 0.05). One case with neutropenic sepsis died. C. difficile was also investigated in the stool samples of 50 hospitalized children treated with antibiotics who did not develop diarrhea. C. difficile toxins A and B were found in 5 children aged < 2 y in the control group. This study shows that C. difficile is an important cause of nosocomial diarrhea in our hospital population.