A PROSPECTIVE-STUDY OF CLOSTRIDIUM-DIFFICILE INFECTION AND COLONIZATION IN PEDIATRIC ONCOLOGY PATIENTS

Background. Patients with cancer often receive broad spectrum antibiot ics in addition to antineoplastic chemotherapy. Both treatments predis pose adult oncology patients to infection and colonization with Clostr idium difficile, but the role of this pathogen in pediatric oncology p atients is poorly defined. Methods. A prospective study of 149 fecal s amples from symptomatic pediatric oncology patients and 58 samples fro m asymptomatic patients was performed. Each sample was analyzed for th e presence of C. difficile and its toxins A and B. Results. In 8.7% of the symptomatic samples and 19% of the asymptomatic samples toxigenic C. difficile was found. No association was found between either the u se of antibiotics and/or the administration of chemotherapy and the pr esence of toxigenic C. difficile. Younger children were more likely to be infected or colonized with C. difficile, and there was no evidence of nosocomial transmission of C. difficile within the study populatio n. Conclusions. As toxigenic C. difficile may form part of the normal flora in young children, this study indicates that in the absence of a defined outbreak, C. difficile does not appear to be an important pat hogen in pediatric oncology patients.