Significance of Clostridium difficile and its cytotoxin in children.

Stools of 147 children belonging to different age groups were examined for the presence of Clostridium difficile, its cytotoxin and other enteric pathogens. None of the 31 full-term neonates, 5 (16%) of the 32 premature neonates, 27 (46%) of the 59 infants and 1 (4%) of the 25 older children excreted C. difficile in their stools. Faecal cytotoxin was only detected in four infants (7%). There was no correlation with diarrhoea, previous antibiotic therapy, type of diet, or the concomitant presence of other intestinal pathogens. We conclude that colonisation of the intestine by C. difficile is probably acquired from environmental sources and that it cannot be regarded as a significant cause of diarrhoea in children.