Clostridium difficile-associated disease in children with solid tumors.

Area of Science:

• Pediatric Oncology
• Infectious Diseases
• Gastroenterology

Background:

• Clostridium difficile-associated disease (CDAD) is a significant healthcare-associated infection.
• Children with cancer, particularly those undergoing chemotherapy, are at increased risk for infections.
• The incidence and presentation of CDAD in pediatric solid tumor patients are not well-defined.

Purpose of the Study:

• To determine the incidence of Clostridium difficile-associated disease (CDAD) in pediatric patients with solid tumors.
• To describe the clinical characteristics and outcomes of CDAD in this vulnerable population.

Main Methods:

• A prospective study was conducted at a children's hospital.
• Children with solid tumors or lymphomas undergoing chemotherapy presenting with abdominal pain were tested for C. difficile toxins A and B.
• Data on clinical symptoms, neutrophil counts, and treatment were collected.

Main Results:

• Nine out of 141 (6%) pediatric solid tumor patients developed C. difficile toxin A positivity with abdominal symptoms.
• Most affected patients had normal neutrophil counts at the onset of gastrointestinal symptoms.
• No patients developed pseudomembranous colitis or died; all had received prior antibiotics and/or antineoplastic agents.

Conclusions:

• Clostridium difficile-associated disease (CDAD) is a potential complication in children with solid tumors.
• CDAD should be considered in the differential diagnosis of abdominal symptoms in pediatric cancer patients, particularly when neutropenia is absent.
• Awareness of CDAD is important due to its potential for severity and epidemic spread.