Clostridium difficile infection in the pediatric surgery population

Area of Science:

• Pediatric Infectious Diseases
• Gastroenterology
• Hospital Epidemiology

Background:

• Clostridium difficile-associated disease (CDAD) incidence has risen significantly in adults.
• Limited research exists on pediatric CDAD, particularly in surgical patients.
• Understanding pediatric CDAD trends is crucial for public health.

Purpose of the Study:

• To characterize Clostridium difficile infection (CDI) in the pediatric population.
• To investigate the incidence and risk factors of pediatric CDAD.
• To focus on the surgical pediatric population for CDAD analysis.

Main Methods:

• A retrospective review of 231 pediatric patient records with CDAD diagnoses.
• Data collected from a university-based children's hospital between 2002 and 2008.
• Analysis of patient demographics, antibiotic use, surgical history, and immunosuppression status.

Main Results:

• Pediatric CDAD incidence increased from 250 to 580 per 100,000 hospitalizations (2002-2008).
• No CDAD-related fatalities or surgical interventions occurred.
• 87% of patients received antibiotics prior to diagnosis; 52% had prior surgery, often in immunosuppressed patients.

Conclusions:

• Pediatric CDAD incidence doubled but was not associated with mortality or operative intervention.
• Previous antibiotic exposure and operative procedures are significant risk factors for pediatric CDAD.
• Immunosuppressed pediatric patients with prior antibiotic use are particularly vulnerable to CDAD.