Related Experiment Video
Updated: Apr 7, 2026
A Protein Microarray Assay for Serological Determination of Antigen-specific Antibody Responses Following Clostridium difficile Infection
Published on: June 15, 2018
Risk Factors for Community-associated Clostridium difficile-associated Diarrhea in Children
Jonathan D Crews1, Lauren R Anderson, D Kim Waller
1From the *Pediatric Infectious Diseases, Baylor College of Medicine, San Antonio, Texas; †Pediatric Infectious Diseases, Baylor College of Medicine, Houston, Texas; ‡University of Texas School of Public Health, Houston, Texas; and §Baylor St. Luke's Medical Center, Houston, Texas.
Insights
Recent cephalosporin use and feeding tubes are key risk factors for Clostridium difficile-associated diarrhea (CDAD) in children. Reducing outpatient antibiotic use may lower community-associated CDAD rates.
Area of Science:
- Pediatric Gastroenterology
- Infectious Diseases
- Epidemiology
Background:
- Community-associated Clostridium difficile-associated diarrhea (CA-CDAD) is rising in pediatric populations.
- Understanding risk factors is crucial for effective prevention and management strategies.
Purpose of the Study:
- To identify risk factors for pediatric CA-CDAD.
- To compare children with CA-CDAD to those with other diarrheal illnesses.
Main Methods:
- Retrospective case-control study at a tertiary care center.
- Matched 69 CA-CDAD cases with controls negative for C. difficile.
- Analyzed demographics, medication exposure, and healthcare encounters using logistic regression.
Main Results:
- Antibiotic exposure within 30 days occurred in 40.6% of CA-CDAD cases.
- Cephalosporin use within 30 days was associated with increased CA-CDAD risk (OR: 3.32).
- Gastrointestinal feeding devices also increased CA-CDAD risk (OR: 2.59).
Conclusions:
- Cephalosporin use and gastrointestinal feeding devices are significant risk factors for pediatric CA-CDAD.
- Reducing outpatient antibiotic prescriptions may mitigate CA-CDAD incidence in children.
Background:
Clostridium difficile-associated diarrhea (CDAD) is increasingly diagnosed in children in community settings. This study aims to assess recent antibiotic use and other risk factors in children with community-associated (CA-) CDAD compared with children with other diarrheal illnesses in a tertiary care setting.
Methods:
Children with CA-CDAD evaluated at Texas Children's Hospital (Houston, TX) from January 1, 2012 to June 30, 2013 were identified. Two control subjects with community-associated diarrhea who tested negative for C. difficile were matched to case subjects. Data on demographics, medication exposure and outpatient healthcare encounters were collected from medical records. Multivariate logistic regression was performed to identify predictors of pediatric CA-CDAD.
Results:
Of 69 CA-CDAD cases, most (62.3%) had an underlying chronic medical condition and 40.6% had antibiotic exposure within 30 days of illness. However, no traditional risk factor for CDAD was identified in 23.2% and 15.9% of CA-CDAD cases within 30 and 90 days of illness onset, respectively. Outpatient healthcare encounters within 30 days were more common among CA-CDAD cases than control subjects (66.7% vs. 48.6%; P = 0.01). In the final multivariate model, CA-CDAD was associated with cephalosporin use within 30 days [odds ratio: 3.32; 95% confidence interval: 1.10-10.01] and the presence of a gastrointestinal feeding device (odds ratio: 2.59; 95% confidence interval: 1.07-6.30).
Conclusions:
Recent use of cephalosporins and the presence of gastrointestinal feeding devices are important risk factors for community- associated CDAD in children. Reduction in the use of outpatient antibiotics may decrease the burden of CA-CDAD in children.
Related Concept Videos
01:18Bacterial Gastroenteritis
01:26Factors Affecting the Risk of Infection
The integrity and count of the white blood cells help the body resist pathogens and fight infection. When impaired, it reduces the body's resistance to pathogens. The acidic pH levels of the gastrointestinal, genitourinary tracts, and skin...
01:18Drugs Affecting GI Tract Motility: Antimicrobials as Antidiarrheal Agents
01:30Development of Human Microbiota
01:27Inflammatory Bowel Disease I: Ulcerative Colitis
Inflammatory bowel disease, or IBD, encompasses a group of disorders characterized by chronic inflammation or ulceration of the gastrointestinal tract.
Risk Factors
The exact cause of IBD remains unclear, although it is believed to be due to a mix of genetic, environmental, microbial, and immune factors. Genetic factors are significant in determining susceptibility to IBD, with family history being a critical risk factor. Individuals with a first-degree relative who has IBD are at...
01:25Clinical Significance of Antibiotic Resistance