NOSOCOMIAL OUTBREAK OF CLOSTRIDIUM-DIFFICILE DIARRHEA IN A PEDIATRIC SERVICE

An outbreak of nosocomial diarrhea that occurred in a pediatric orthop edic service between 1 December 1993 and 15 April 1994 is reported, A total of 37 patients (mean age, 9.6 years; range, 2 months-19.3 years) were involved in the outbreak, including six patients with bacteriolo gically documented Clostridium difficile infection, A multivariate ana lysis identified lincomycin treatment for at least three days as the o nly significant risk factor, Stool samples from four asymptomatic pati ents were also positive for Clostridium difficile and its cytotoxins, Isolates from all patients belonged to serogroup C, were highly resist ant to lincomycin, and exhibited the same restriction pattern by pulse d-field gel electrophoresis. The outbreak ended after treatment with l incomycin was discontinued and hygiene control measures were implement ed.