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Novel risk factors for recurrent Clostridium difficile infection in children

Maribeth R Nicholson1, Isaac P Thomsen, James C Slaughter

  • 1*Division of Pediatric Gastroenterology, Hepatology, and Nutrition †Division of Pediatric Infectious Disease, Vanderbilt University School of Medicine ‡Department of Biostatistics, Vanderbilt University, Nashville, TN.

Journal of Pediatric Gastroenterology and Nutrition
|September 9, 2014
PubMed

Insights

Recurrent Clostridium difficile infection (rCDI) affects 22% of children. Key risk factors for rCDI in pediatric patients include malignancy, recent surgery, and multiple antibiotic exposures.

Area of Science:

  • Pediatric Infectious Diseases
  • Gastroenterology
  • Epidemiology

Background:

  • Clostridium difficile infection (CDI) is a frequent cause of antibiotic-associated diarrhea in children.
  • High recurrence rates of CDI are documented in adults, but pediatric data are limited.
  • Understanding pediatric recurrent CDI (rCDI) is crucial for effective management.

Purpose of the Study:

  • To determine the incidence of rCDI in pediatric patients.
  • To identify risk factors associated with rCDI in children.
  • To inform clinical practice and targeted interventions for pediatric rCDI.

Main Methods:

  • Retrospective cohort study of 186 pediatric patients with primary CDI.
  • Defined rCDI as symptom recurrence and positive testing within 60 days of therapy completion.
  • Compared patients with rCDI to those without recurrence.

Main Results:

  • The incidence of rCDI was 22% among the studied pediatric population.
  • Malignancy, recent surgery, and number of antibiotic exposures by class were significant risk factors for rCDI on multivariable analysis.
  • Other univariable factors included hospitalization, antibiotic use, acid blocker use, and immunosuppressant use.

Conclusions:

  • Pediatric rCDI occurs in 22% of cases.
  • Malignancy, recent surgery, and broad-spectrum antibiotic exposure are significant predictors of rCDI in children.
  • These findings highlight the need for vigilant monitoring and tailored treatment strategies in high-risk pediatric populations.
Abstract

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