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Analysis of Clostridioides difficile Infection in Children with Diarrhea in Two Hospitals in Southern Brazil.
Maestri, Adriane C; Mesa, Dany; Vasconcelos, Thais M; Krul, Damaris; Ricieri, Marinei C; Motta, Fabio A; Dalla-Costa, Libera M; Raboni, Sonia M; Nogueira, Keite S.
Afiliação
  • Maestri AC; Laboratório de Bacteriologia, Complexo Hospital de Clínicas da Universidade Federal do Paraná, Rua Padre Camargo, 280 - Alto da Glória, CEP: 80.062-240, Curitiba, Paraná, Brazil.
  • Mesa D; Programa de Pós-Graduação em Medicina Interna e Ciências da Saúde, Universidade Federal do Paraná, Curitiba, Paraná, Brazil.
  • Vasconcelos TM; Faculdades Pequeno Príncipe/ Instituto de Pesquisa Pelé Pequeno Príncipe, Curitiba, Paraná, Brazil.
  • Krul D; Faculdades Pequeno Príncipe/ Instituto de Pesquisa Pelé Pequeno Príncipe, Curitiba, Paraná, Brazil.
  • Ricieri MC; Faculdades Pequeno Príncipe/ Instituto de Pesquisa Pelé Pequeno Príncipe, Curitiba, Paraná, Brazil.
  • Motta FA; Hospital Pequeno Príncipe, Curitiba, Paraná, Brazil.
  • Dalla-Costa LM; Hospital Pequeno Príncipe, Curitiba, Paraná, Brazil.
  • Raboni SM; Faculdades Pequeno Príncipe/ Instituto de Pesquisa Pelé Pequeno Príncipe, Curitiba, Paraná, Brazil.
  • Nogueira KS; Programa de Pós-Graduação em Medicina Interna e Ciências da Saúde, Universidade Federal do Paraná, Curitiba, Paraná, Brazil.
Curr Microbiol ; 80(12): 390, 2023 Oct 26.
Article em En | MEDLINE | ID: mdl-37884782
Clostridioides difficile infection (CDI) has been increasingly observed in children, but there is a lack of epidemiological and molecular data on CDI in Latin America. This prospective cohort study aimed to investigate the role of CDI in children with diarrhea. It included 105 children with antimicrobial-associated diarrhea (AAD) and analyzed the molecular characteristics of strains isolated from two hospitals in southern Brazil between 2017 and 2020. Fecal samples from the participants were tested for glutamate dehydrogenase (GDH) and A/B toxins using a rapid enzyme immunoassay. GDH-positive samples underwent automated real-time polymerase chain reaction and toxigenic culture. Toxigenic C. difficile isolates were selected for whole genome sequencing. Out of the 105 patients, 14 (13.3%) met the criteria for CDI. Children with a history of previous CDI and the presence of mucus in their stool were more likely to have CDI. Metronidazole was the most used treatment (71.4%), and three patients (23.1%) experienced CDI recurrence (rCDI). Although the number of sequenced isolates was limited, a wide diversity of sequence types (ST) was observed. In addition to toxin genes (tcdA, tcdB, cdtA, and cdtB), the isolates also exhibited virulence factors involved in adhesion (cwp66, groEL, slpA, fbpA/fbp68) and immune evasion (rmlA, rmlB, rmlC, gnd, rfbA-1), along with multiple resistance factors (gyrA mutation, norA, ermB, dfrF, and vanG). These findings highlight the prevalence and recurrence of CDI among hospitalized children. Longitudinal studies are needed to better understand the characteristics of CDI-associated diarrhea and its impact on the healthcare system in this population.
Assuntos

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Toxinas Bacterianas / Clostridioides difficile / Infecções por Clostridium Limite: Child / Humans País/Região como assunto: America do sul / Brasil Idioma: En Revista: Curr Microbiol Ano de publicação: 2023 Tipo de documento: Article País de afiliação: Brasil País de publicação: Estados Unidos

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Toxinas Bacterianas / Clostridioides difficile / Infecções por Clostridium Limite: Child / Humans País/Região como assunto: America do sul / Brasil Idioma: En Revista: Curr Microbiol Ano de publicação: 2023 Tipo de documento: Article País de afiliação: Brasil País de publicação: Estados Unidos