Background: The increasing colonization with Clostridioides difficile in paediatric hospitalized population is a well known event; however, its prevalence in Iranian children has not effectively been identified yet.
Objective: The objective of this study was to determine the intestinal-carriage rates of C. difficile and molecular characterization of C. difficile in the Ilamian pediatric population from May 22, 2018, until September 22, 2018.
Materials and methods: Eighty samples were obtained from 40 children aged <5 years, at day 0 of their hospitalization (N=40 samples), to determine community-associated colonization, and then at day 5 days after hospitalization (N=40 samples), to determine healthcare associated colonization. The stool samples were examined for C. difficile, and isolated strains were evaluated for production of Clostridial toxins A/B and molecular characterizations.
Results: The colonization rates of C. difficile and toxigenic C. difficile were 10% (8/80) and 3.75% (3/80), respectively. Based on the age group, the intestinal-carriage rates of C. difficile were 37.5, 50, and 12.5% in children ≤ 1, 1-3, and 3-5 years old, respectively. Our findings have revealed eight distinct ribotypes. Our findings have revealed eight distinct ribotypes of C. difficile isolates. Three out of 8 (37.5%) of C. difficile isolates were considered as community-associated colonization and belonged to ribotypes 7, 8, and 9. Conclusion. Our findings suggest the need of confirmation by further epidemiological studies in Iranian children. Given that the 37.5% of cases observed were community-associated, estimates of the incidence of C. difficile infections, that include only hospitalized children, may largely underestimate the burden of disease in children.
Keywords: Clostridioides difficile; bacterial colonization; children.