Diagnosis and treatment of recurrent clostridium difficile infection in children

Abstract

Clostridium difficile(CD), a gram-positive, spore-forming, obligate anaerobic bacillus, is a leading cause of antibiotic-associated diarrhea(AAD)worldwide.With the widespread use of broad-spectrum antibiotics, the incidence of clostridium difficile infection in children is rising, while recurrent clostridium difficile infection(RCDI)requires prolonged treatment and higher medical costs.Malignancy, recent surgery and antibiotic exposures have been identified as the risk factors in children.While the toxigenic strains culture and the cell cytotoxicity neutralization assay are gold standard for the diagnosis, new diagnostic approaches such as nucleic acid amplification method have become available.The use of antibiotics, fecal microbiota transplantation(FMT)or monoclonal antibodies are included in the current treatments for RCDI.This review will cover published studies to discuss the risk factors, diagnosis and treatment of RCDI in children. Key words: Recurrent clostridium difficile infection; Antibiotic-associated diarrhea; Children