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Epidemiology and risk factors for Clostridium difficile infection in children

Thomas J Sandora1, Monica Fung, Kathleen Flaherty

  • 1Division of Infectious Diseases, Children's Hospital Boston, Boston, MA 02115, USA. thomas.sandora@childrens.harvard.edu

The Pediatric Infectious Disease Journal
|January 15, 2011
PubMed

Insights

Pediatric Clostridium difficile infection (CDI) is rising. Risk factors include organ transplants, G or J tubes, and recent antibiotic use, while prior hospitalization is protective.

Area of Science:

  • Pediatric Infectious Diseases
  • Hospital Epidemiology
  • Microbiology

Background:

  • Pediatric Clostridium difficile infection (CDI) hospitalizations are increasing.
  • Understanding pediatric CDI epidemiology is crucial for effective management.

Purpose of the Study:

  • To describe the epidemiology of pediatric CDI at a quaternary care hospital.
  • To identify independent predictors of pediatric CDI.

Main Methods:

  • Nested case-control study of children <18 years tested for C. difficile (Jan-Aug 2008).
  • Included patients ≥1 year with positive test and diarrhea; excluded presumed colonization.
  • Used multivariate logistic regression to identify independent predictors.

Main Results:

  • Solid organ transplant (OR, 8.09), lack of prior hospitalization (OR, 8.43), G or J tube (OR, 3.32), and recent fluoroquinolone (OR, 17.04) or nonquinolone antibiotics (OR, 2.23) were predictors.
  • Receipt of C. difficile-active antibiotics within 24 hours was associated with lower odds of CDI (OR, 0.22).

Conclusions:

  • Recent antibiotic exposure and comorbid conditions like organ transplant and G or J tubes are associated with pediatric CDI.
  • Diagnostic utility of CDI testing is reduced in patients receiving C. difficile-active antibiotics.
Abstract

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