Affiliations: Department of Pediatrics, Pediatric Infections
Research Center, Mofid Children Hospital, Shaheed Beheshti University of
Medical Sciences, Tehran, Iran | Department of Clinical Microbiology, Mofid Children
Hospital, Shaheed Beheshti University of Medical Sciences, Tehran, Iran
Note:  Correspondence: Dr. Delara Babaie, Pediatric Infectious
Research Center, Mofid Children Hospital, Shariati Street, Tehran, 15468-15514,
Iran. Tel.: +98 2122367984; Fax: +98 2122226941; E-mail: [email protected]
Abstract: Clostridium difficile is a Gram positive, spore-forming organism
that has become a significant cause of nosocomial infection in hospitalized
adults. Colonization with this organism results in a wide spectrum of clinical
conditions, including an asymptomatic carrier state, mild self-limited
diarrhea, pseudomembranous colitis, and fulminant colitis. It's role in disease
in children remains controversial. This is a prospective study in which we
evaluated all the patients hospitalized in the infectious diseases ward of
Mofid Children's Hospital, Tehran during 12 months (between September 2006 and
September 2007). Stool samples from 250 patients were cultured for C.
difficile and specimens analyzed for detection of toxin A and B. Data were
analyzed by SPSS software version 11.5. Stool culture was positive for C.
difficile in 113 (45.2%) patients, 10 (4%) of these were positive for
both toxins A and B by enzyme-linked immunosorbent assay (ELISA). ELISA was
negative in all patients with negative culture. None of the variables tested
(age and antibiotic exposure) was significantly correlated with colonization.
This is the first study about colonization rates of C. difficile in
children in Iran. We conclude that although the C. difficile colonization
rate in our children is high (45.2%), the rate of toxigenic strains is low
(4%). This may explain the low rate of C. difficile associated disease
(CACD) in our population.