Rivista di formazione e aggiornamento professionale del pediatra e del medico di base, fondata nel 1982. In collaborazione con l'Associazione Culturale Pediatri.
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Infezione da Clostridioides difficile nel neonato e nel lattante: una malattia... "difficile"!

Clostridioides difficile infection in newborns and infants: a really "difficult" disease!

Gregorio Serra, Francesco Pollari, Maria Rita Di Pace, Mario Giuffrè, Veronica Notarbartolo, Maria Sergio, Marco Pensabene, Giovanni Corsello
Dipartimento Materno-Infantile, Università degli Studi di Palermo

Marzo 2026 | DOI: 10.53126/MEBXXIXM051

Abstract
Clostridioides difficile (C. difficile) is the leading cause of infection among patients on antibiotic therapy, with disease severity (CDI) varying by age and patient charac-teristics, ranging from asymptomatic to severe cases such as diarrhoea and septic shock. CDI is seldom observed in newborns due to the immaturity of their intestinal mucosa, which lacks receptors for toxins. Even with its low incidence in this population, clinicians must remain vigilant for its diagnosis when risk factors are present. The article reviews epidemiological data, diagnostic methods and case reports, including a severe CDI case in a new-born with Down syndrome who developed septic shock after antibiotic therapy. The analysis emphasises the importance of suspecting C. difficile infection in patients with severe diarrhoea, particularly those with risk factors like congenital malformations and prolonged antibiotic use. Furthermore, the paper outlines an appropriate diagnostic approach, recommending ELISA immunoassays for detecting glutamate dehydrogenase and toxins, followed by confirmatory tests if needed. Oral vancomycin is the preferred treatment, with additional supportive measures recommended for severe cases.
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Classificazione MeSH
Chemical Actions and Uses Pharmacologic Actions Therapeutic Uses Anti-Infective Agents Anti-Bacterial Agents (363)
Infections Bacterial Infections and Mycoses Bacterial Infections Gram-Positive Bacterial Infections Clostridium Infections
Pathological Conditions, Signs and Symptoms Signs and Symptoms Signs and Symptoms, Digestive Diarrhea (60)
Nervous System Diseases Neurologic Manifestations Neurobehavioral Manifestations Intellectual Disability Down Syndrome (38)
Investigative Techniques Immunologic Techniques Immunoassay Immunoenzyme Techniques Enzyme-Linked Immunosorbent Assay (7)
Persons Age Groups Infant Infant, Newborn (284)