Objective: Clostridium difficile
is a gram-positive, anaerobic, spore-forming bacillus. Usually it does not cause
disease unless a patient who is colonized with toxin-producing strains has been treated with antibiotics,
particularly those that change the anaerobic flora of the large intestine.
We investigated in a prospective study intestinal colonization of C. difficile
and its toxins in children
with malignancy that used different antibiotics and cytotoxic drugs.
One hundred fifty-two patients were included in this prospective study. Stool samples were
obtained within the first 48 hours after admission and cultured for C. difficile
; cytopathic effect of C. difficile
was detected on HELA cells, also ELISA test was performed for detection of toxins A and B. 25% of patients
had positive culture for C. difficile
; 36/38 (92%) revealed positive cytopathic effect on HELA cells. No
significant relation was found between age, gender, history of antibiotic consumption and C. difficile
culture and cytopathic effect on HELA cells. The only relation was seen between cotrimoxazol usage and
cytopathic effect on HELA cells (P
Although the rate of C. difficile
colonization (25.6%) and toxigenic strains (23.7%) in admitted
children in hematologic ward is high, the rate of ELISA positive test for toxin A+B was not correspond with
culture and cytopatic effect on HELA cell. With respect to sensitivity and specificity of ELISA test, possibility
for existence of toxin C with cytopathic effect is high in this type of patients.