Clostridium difficile infection and colonisation in children under 3 years of age: prospective comparative study.

AIMS: Despite an increasing trend in Clostridium difficile infections (CDI) and high C. difficile colonization rate especially among younger children, infants remain quite resistant to the disease. The goals of this study were to distinguish whether there exists a difference in CDI between children with or without diarrhoea, ascertain the prevalence of CDI, and assess CDI severity in children under 3 years with diarrhoea in our institution. METHODS: A prospective study was conducted from May 2015 to June 2016. Children 3 years of age or younger were enrolled and into two groups. Every faecal sample was tested using a diagnostic two-step screening algorithm including an immunochromatographic test and polymerase chain reaction. RESULTS: The study enrolled 147 children with diarrhoea and 75 control patients. The prevalence of CDI in children with diarrhoea was 2% (3/147), the prevalence of toxigenic C. difficile in the diarrhoeal group compared to the control group was 11.6 % (17/147) vs. 10.6% (8/75) (p.

Clinical and microbiological characteristics of Clostridium difficile infection in children hospitalized at the Departement of Paediatric Infectious Diseases in Brno between 2013 and 2017.

AIMS: Clostridium difficile (C. difficile) plays a minor but important role in paediatrics. The aims of this study were to objectivise data, to show their significance in clinical practice, and to present our experience with the treatment of paediatric patients. MATERIALS AND METHODS: A retrospective study was conducted in patients (0-19 years of age) hospitalized for Clostridium difficile infection (CDI) in the Department of Paediatric Infectious Diseases, University Hospital in Brno between 2013 and 2017. Each patient was tested using a two-step diagnostic screening algorithm including immunochromatography and polymerase chain reaction assays. RESULTS: Thirty-five patients with a median age of 10.3 years (range 1-17.5 years) were enrolled in the study. Almost 70% of patients were aged between 6 and 19 years. No risk factor was identified in one patient, 41.6% of cases were patients with malignancy or inflammatory bowel disease, and 2.5% of patients had short bowel syndrome. After targeted CDI treatment, the median time to resolution of diarrhoea was 2.5 days. Metronidazole was used in more than half of cases. Five patients received fidaxomicin, which was well tolerated. Metronidazole failed in three cases. Recurrence after incomplete treatment with metronidazole occurred in one patient. Health care-associated CDI was recorded in 86% of cases. Recurrent CDI was reported in four children (two with malignancy, one with inflammatory bowel dissease, and one with short bowel syndrome). CONCLUSIONS: The course of CDI is generally mild in the paediatric population. CDI without a risk factor is rare. Paediatric patients respond well to metronidazole. Fidaxomicin was well tolerated by all patients. We prefer the treatment with fidaxomicin in high-risk groups (immunocompromised condition, inflammatory bowel disease, and short bowel syndrome).

Antioxidant Properties of 2-Hydroxyethyl Methacrylate-Based Copolymers with Incorporated Sterically Hindered Amine.

A series of model linear copolymers of 2-hydroxyethyl methacrylate (HEMA) and a sterically hindered amine derivative [N-(2,2,6,6-tetramethyl-piperidin-4-yl)methacrylamide (HAS)] were synthesized and characterized. Scavenging activities of the copolymers against reactive oxygen species (peroxyl and hydroxyl radicals) and 2,2-diphenyl-1-picrylhydrazyl (DPPH) radicals were determined. It was found that copolymers with medium HAS content (3.5-4.0 mol %) were better scavengers than copolymers with lower and higher HAS content and also than polyHEMA and polyHAS homopolymers and the HAS monomer. Importantly, these copolymers compared favorably even to established low-molecular weight antioxidant standards (BHA and dexpanthenol). Monomer reactivity ratios were determined, and the microstructure of the copolymers was assessed. Subsequently, cross-linked copolymers in the powder and film forms with optimal HAS content were synthesized. Their scavenging activities against the three types of radicals were determined, revealing that these hydrogels are potent scavengers of reactive oxygen species.

Synthesis of poly[N-(2-hydroxypropyl)methacrylamide] conjugates of inhibitors of the ABC transporter that overcome multidrug resistance in doxorubicin-resistant P388 cells in vitro.

The effects of novel polymeric therapeutics based on water-soluble N-(2-hydroxypropyl)methacrylamide copolymers (P(HPMA)) bearing the anticancer drug doxorubicin (Dox), an inhibitor of ABC transporters, or both, on the viability and the proliferation of the murine monocytic leukemia cell line P388 (parental cell line) and its doxorubicin-resistant subline P388/MDR were studied in vitro. The inhibitor derivatives 5-methyl-4-oxohexanoyl reversin 121 (MeOHe-R121) and 5-methyl-4-oxohexanoyl ritonavir ester (MeOHe-RIT), showing the highest inhibitory activities, were conjugated to the P(HPMA) via the biodegradable pH-sensitive hydrazone bond, and the ability of these conjugates to block the ATP driven P-glycoprotein (P-gp) efflux pump was tested. The P(HPMA) conjugate P-Ahx-NH-N═MeOHe-R121 showed a dose-dependent increase in the ability to sensitize the P388/MDR cells to Dox from 1.5 to 24 µM, and achieved an approximately 50-fold increase in sensitization at 24 µM. The P(HPMA) conjugate P-Ahx-NH-N═MeOHe-RIT showed moderate activity at 6 µM (∼10 times higher sensitization) and increased sensitization by 50-fold at 12 µM. The cytostatic activity of the P(HPMA) conjugate P-Ahx-NH-N═MeOHe-R121(Dox) containing Dox and the P-gp inhibitor MeOHe-R121, both bound via hydrazone bonds to the P(HPMA) carrier, was almost 30 times higher than that of the conjugate P-Ahx-NH-N═Dox toward the P388/MDR cells in vitro. A similar result was observed for P-Ahx-NH-N═MeOHe-RIT(Dox), which exhibited almost 10 times higher cytostatic activity than P-Ahx-NH-N═Dox.