Clostridium difficile “superbug” found in children

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Toltzis et al from Cleveland and Philadelphia report the first evidence of North American Pulsed Field type 1 (NAP1) strains of Clostridium difficile affecting children. This hypervirulent strain of C. difficile, which is deficient in genes that down regulate toxin production, has been responsible for severe, sometimes fatal, colitis in adults. In the Cleveland-Philadelphia “snapshot” reported in this issue of The Journal, almost 20% of C. difficile isolates from children hospitalized with gastrointestinal illness were the NAP1 strain. Considering facilitated transmissibility of diarrheal pathogens in children, this finding gives pause for concern.