Isolation of Toxin Producing Clostridium difficile from Two Children with Oxacillin- and Dicloxacillin-Associated Diarrhea

¹ Department of Infectious Diseases and Clinical Microbiology Laboratories, Children's Hospital National Medical Center, George Washington University School of Medicine and Health Sciences, Washington, District of Columbia

Clostridium difficile was isolated from the feces of two infants who had developed watery diarrhea with blood-tinged stain. One child suffered from diarrhea after five days of parenteral oxacillin therapy; the diarrhea subsided within three days of cessation of therapy. The other infant developed diarrhea following four days of oral dicloxacillin; the diarrhea subsided within two days of cessation of therapy. C difficile was no longer detectable in the stools of the infants at that time. Tissue culture assay showed the presence of preformed fecal toxin and demonstrated the toxigenicity of the fecal isolates of C difficile and reference strains. These findings show that C difficile may play a role in diarrhea associated with oxacillin and dicloxacillin in children.