Incidence of cytotoxin producing isolates of Clostridium difficile in faeces of neonates and children in Nigeria.

One hundred and fifty six (156) confirmed isolates of Clostridium difficile from faeces of neonates and children in parts of Anambra State, Nigeria were screened and assayed for cytotoxin production by the tissue culture technique and the frequency of occurrence estimated. Twenty three out of 156 isolates were found to be cytotoxin positive isolates representing a frequency of 14.8%. There was no difference between the frequency of occurrence of cytotoxin positive isolates in neonates and children from rural and urban areas. Infants in the age group of one dy to 1 yr showed 16.7% frequency of occurrence of cytotoxin positive isolates, with toxin titers between 5 to 1280, 10% for children of 1-2 yrs age group, with titers between 5 to 40 and 8.3% for children of 2 to 3 yrs age group with titers of 5 and 10. No cytotoxin positive isolate was detected from children of the 3 to 5 yrs age group. Children fed by formula foods alone showed a 50% frequency of occurrence of cytotoxin positive isolates, children fed by breast milk plus formula supplementation, 19.23% and breast milk alone 17.5%. There was no significant difference in the frequency of occurrence of cytotoxin positive isolates in faeces from diarrhoeal and non diarrhoeal cases. It appears therefore, that age and mode of feeding are important factors that influence intestinal colonization of cytotoxin producing isolates of C. difficile in neonates and children.