Clostridium difficile cytotoxin in a pediatric population.

Assays for cytotoxin of Clostridium difficile were performed on stool samples submitted to the laboratory for routine microbiologic study. Cytotoxin was recovered from 8.6% of 208 pediatric patients studied. Cytotoxin was identified significantly more often in younger patients (median age, 11 months) and in those with hospital-associated illness (17%) and antibiotic-associated illness (18%). Hospitalization and antibiotic use were significant independent risk factors. Clinical diagnoses in patients with C difficile cytotoxin included classic pseudomembranous colitis, acute self-resolving diarrheal syndrome, chronic diarrhea with failure to thrive, infant botulism, and asymptomatic carriage.