الفهرس 
HOSPITAL ACQUIRED INFECTIONS
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Abstract
Background: Once a nosocomial diarrhea, Clostridium difficile infection (CDI) now appears frequently in exposure to antibiotics, the incidence of Clostridium difficile-associated diarrhea (CDAD) is increasing worldwide, So this clinical study was carried to evaluate children who developed diarrhea during hospitalization in Children’s hospital, Ain shams university.
Aim: This study measure the frequency of clostridium difficile as a cause of nosocomial diarrhea and also determine the risk factor associated with the development of Clostridium difficile-associated diarrhea in children.
Patients and Methods: Fifty patients suffering from diarrhea, admitted in Ain Shams Pediatric Hospital over a period of 8 months (April - November, 2013) were enrolled in the study. All enrolled patients were subjected to detailed history documentation, clinical examination and laboratory investigations in the form of complete blood count (CBC), C-reactive protein (CRP) at admission and after onset of diarrhea, Stool samples of patients with diarrhea that developed 3 or more days after hospital admission were submitted for stool analysis and culture, detection of clostridium difficile by using Toxigenic Clostridium difficile selective medium( cycloserine cefoxitin fructose agar (CCFA).
Results: The frequency of nosocomial diarrhea was 1045/100,000, Clostridium difficile represented 18% of cases with ND, the frequency of clostridium difficile associated diarrhea was 188/100,000 of hospitalized children, The cause of nosocomial diarrhea was found to be viral diarrhea 60% of patients, bacterial diarrhea 28% of patient and the parasitic cause 12% of patients, the antibiotic combinations was found to be the independent risk factor for the clostridium infection.
Conclusions: CDI is considered to be the main cause of bacterial infectious diarrhea in nosocomial settings and receiving combinations of antibiotics represents the main risk to develop diarrhea associated to C.difficile.