Clostridium difficile associated diarrhea in pediatric oncology patients receiving chemotherapy

Abstract EN

Background: Nowadays, patients with cancer receive more intensive chemotherapeutic regimens together with broad spectrum antibiotics during periods of profound immunosuppression.

Thus, cancer patients are susceptible to infection with clostridium difficile but the role of this pathogen in pediatric oncology patients is poorly defined.

Patients and methods: The prevalence of C.

difficile infection in pediatric oncology patients with diarrhea following chemotherapy was prospectively monitored, by testing for the presence of its A toxin, at National Cancer Institute, Cairo University.

Results: C.

difficile toxin A was detected in fifteen (14.4%) of 104 diarrhea episodes following chemotherapy.

Hospitalization, the use of antibiotics and relapsing disease were found to be significantly associated with this pathogen.

Two outbreaks were observed.

Severe enterocolitis with dehydration was significantly associated with C.

difficile than with other causes of diarrhea.

Case fatality rate directly attributable to C.

difficile infection was 20%.

Conclusion: C.

difficile is an important cause of diarrhea following intensive chemotherapeutic protocols and is associated with prolonged hospital stay and antibiotic use.

Moreover, C.

difficile have shown a strong association with morbidity and increased mortality and should be searched for as a cause of diarrhea in hospitalized pediatric cancer patients receiving empirical antibiotics