Skip to main content
Archives of Disease in Childhood logoLink to Archives of Disease in Childhood
. 1993 Aug;69(2):221–224. doi: 10.1136/adc.69.2.221

Prolonged carriage of Clostridium difficile in Hirschsprung's disease.

S P Hardy 1, R Bayston 1, L Spitz 1
PMCID: PMC1029461  PMID: 8215525

Abstract

The role of Clostridium difficile in the aetiology of diarrhoea in children with Hirschsprung's disease was investigated in a prospective longitudinal study. In 64 children with Hirschsprung's disease no significant difference was found in the isolation rate of C difficile in patients with diarrhoea (32%) and without diarrhoea (26%). Comparable isolation rates were found in 47 control children with and without diarrhoea (27% and 16% respectively). The number of strains producing toxin B was similar in the four groups of children. In contrast to the disappearance of C difficile by 12 months of age in the control groups of children, C difficile could be repeatedly isolated from a proportion of children with Hirschsprung's disease over 12 months of age. These findings help to reconcile the existing contradictory reports on the incidence of C difficile in Hirschsprung's disease associated enterocolitis.

Full text

PDF
224

Images in this article

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Brearly S., Armstrong G. R., Nairn R., Gornall P., Currie A. B., Buick R. G., Corkery J. J. Pseudomembranous colitis: a lethal complication of Hirschsprung's disease unrelated to antibiotic usage. J Pediatr Surg. 1987 Mar;22(3):257–259. doi: 10.1016/s0022-3468(87)80341-x. [DOI] [PubMed] [Google Scholar]
  2. George R. H. The carrier state: Clostridium difficile. J Antimicrob Chemother. 1986 Jul;18 (Suppl A):47–58. doi: 10.1093/jac/18.supplement_a.47. [DOI] [PubMed] [Google Scholar]
  3. Ikeda K., Goto S. Diagnosis and treatment of Hirschsprung's disease in Japan. An analysis of 1628 patients. Ann Surg. 1984 Apr;199(4):400–405. doi: 10.1097/00000658-198404000-00005. [DOI] [PMC free article] [PubMed] [Google Scholar]
  4. Kleinhaus S., Boley S. J., Sheran M., Sieber W. K. Hirschsprung's disease -- a survey of the members of the Surgical Section of the American Academy of Pediatrics. J Pediatr Surg. 1979 Oct;14(5):588–597. doi: 10.1016/s0022-3468(79)80145-1. [DOI] [PubMed] [Google Scholar]
  5. Nixon H. H. Hirschsprung's disease: progress in management and diagnostics. World J Surg. 1985 Apr;9(2):189–202. doi: 10.1007/BF01656312. [DOI] [PubMed] [Google Scholar]
  6. Phua T. J., Rogers T. R., Pallett A. P. Prospective study of Clostridium difficile colonization and paracresol detection in the stools of babies on a special care unit. J Hyg (Lond) 1984 Aug;93(1):17–25. doi: 10.1017/s0022172400060885. [DOI] [PMC free article] [PubMed] [Google Scholar]
  7. Richardson S. A., Alcock P. A., Gray J. Clostridium difficile and its toxin in healthy neonates. Br Med J (Clin Res Ed) 1983 Sep 24;287(6396):878–878. doi: 10.1136/bmj.287.6396.878. [DOI] [PMC free article] [PubMed] [Google Scholar]
  8. Sherman J. O., Snyder M. E., Weitzman J. J., Jona J. Z., Gillis D. A., O'Donnell B., Carcassonne M., Swenson O. A 40-year multinational retrospective study of 880 Swenson procedures. J Pediatr Surg. 1989 Aug;24(8):833–838. doi: 10.1016/s0022-3468(89)80548-2. [DOI] [PubMed] [Google Scholar]
  9. Stark P. L., Lee A., Parsonage B. D. Colonization of the large bowel by Clostridium difficile in healthy infants: quantitative study. Infect Immun. 1982 Mar;35(3):895–899. doi: 10.1128/iai.35.3.895-899.1982. [DOI] [PMC free article] [PubMed] [Google Scholar]
  10. Tariq G. M., Brereton R. J., Wright V. M. Complications of endorectal pull-through for Hirschsprung's disease. J Pediatr Surg. 1991 Oct;26(10):1202–1206. doi: 10.1016/0022-3468(91)90335-q. [DOI] [PubMed] [Google Scholar]
  11. Thomas D. F., Fernie D. S., Bayston R., Spitz L., Nixon H. H. Enterocolitis in Hirschsprung's disease: a controlled study of the etiologic role of Clostridium difficile. J Pediatr Surg. 1986 Jan;21(1):22–25. doi: 10.1016/s0022-3468(86)80644-3. [DOI] [PubMed] [Google Scholar]
  12. Thomas D. F., Fernie D. S., Malone M., Bayston R., Spitz L. Association between Clostridium difficile and enterocolitis in Hirschsprung's disease. Lancet. 1982 Jan 9;1(8263):78–79. doi: 10.1016/s0140-6736(82)90216-1. [DOI] [PubMed] [Google Scholar]
  13. Tullus K., Aronsson B., Marcus S., Möllby R. Intestinal colonization with Clostridium difficile in infants up to 18 months of age. Eur J Clin Microbiol Infect Dis. 1989 May;8(5):390–393. doi: 10.1007/BF01964052. [DOI] [PubMed] [Google Scholar]
  14. Viscidi R., Willey S., Bartlett J. G. Isolation rates and toxigenic potential of Clostridium difficile isolates from various patient populations. Gastroenterology. 1981 Jul;81(1):5–9. [PubMed] [Google Scholar]
  15. Wexler H., Mulligan M. E., Finegold S. M. Polyacrylamide gel electrophoresis patterns produced by Clostridium difficile. Rev Infect Dis. 1984 Mar-Apr;6 (Suppl 1):S229–S234. doi: 10.1093/clinids/6.supplement_1.s229. [DOI] [PubMed] [Google Scholar]
  16. Wilson-Storey D., Scobie W. G., McGenity K. G. Microbiological studies of the enterocolitis of Hirschsprung's disease. Arch Dis Child. 1990 Dec;65(12):1338–1339. doi: 10.1136/adc.65.12.1338. [DOI] [PMC free article] [PubMed] [Google Scholar]

Articles from Archives of Disease in Childhood are provided here courtesy of BMJ Publishing Group

RESOURCES