Complicated Clostridium difficile colitis in children with cystic fibrosis: association with gastric acid...

Area of Science:

• Gastroenterology
• Pulmonology
• Infectious Diseases

Background:

• Patients with cystic fibrosis (CF) exhibit risk factors for Clostridium difficile colonization, including frequent hospitalizations and broad-spectrum antibiotic use.
• Despite high colonization rates, Clostridium difficile infection (CDI) is infrequently observed in CF patients.

Observation:

• Three children with CF presented with severe community-associated CDI.
• These children had complicated clinical courses, with one fatality.
• Notably, these patients were generally healthy, with no significant comorbidities, frequent hospitalizations, or recent antibiotic exposure.

Findings:

• The occurrence of three severe CDI cases in a short period suggests a potential link between CF and severe CDI.
• Gastric acid suppression, common in CF patients, is explored as a potential risk factor for CDI.
• The gastrointestinal tract in CF patients is investigated for factors contributing to high C. difficile colonization rates.

Implications:

• This case series highlights the possibility of severe CDI in seemingly healthy CF patients.
• Further research is warranted to elucidate the specific mechanisms and risk factors for CDI in the CF population.
• Understanding these factors may lead to improved prevention and management strategies for CDI in individuals with CF.