Related Experiment Video
Updated: Mar 29, 2026
Fecal Microbiota Transplantation via Colonoscopy for Recurrent C. difficile Infection
Published on: December 8, 2014
Investigation of a cluster of Clostridium difficile infections in a pediatric oncology setting
Raymund Dantes1, Erin E Epson2, Samuel R Dominguez3
1Division of Healthcare Quality Promotion, Centers for Disease Control and Prevention, Atlanta, GA; Epidemic Intelligence Service, Scientific Education and Professional Development Program Office, Centers for Disease Control and Prevention, Atlanta, GA.
Insights
An increase in Clostridium difficile infection (CDI) cases in pediatric oncology patients was linked to specific hospital wards and antibiotic use. Enhanced infection control measures helped reduce CDI rates.
Area of Science:
- Infectious Diseases
- Pediatric Oncology
- Hospital Epidemiology
Background:
- Investigated a rise in Clostridium difficile infection (CDI) cases within a pediatric oncology patient population.
- Observed an increase in hospital-onset CDI during the summer of 2012.
Purpose of the Study:
- Identify risk factors associated with CDI in pediatric oncology patients.
- Assess infection prevention and antimicrobial prescribing practices.
- Understand transmission dynamics of CDI.
Main Methods:
- Conducted a case-control study for CDI risk factor identification.
- Evaluated infection prevention strategies and antimicrobial use.
- Performed environmental sampling and pulsed-field gel electrophoresis for isolate strain-typing.
Main Results:
- Hospitalization in the bone marrow transplant ward and exposure to CT scans or cefepime were independent CDI risk factors.
- Increased cefepime use correlated with a practice change for neutropenic fever.
- Enhanced infection prevention, including cleaning and isolation, led to decreased CDI rates.
Conclusions:
- Strain diversity suggests complex transmission modes requiring further investigation.
- Need for strategies to reduce patient susceptibility to CDI.
- Further research on cefepime's role in CDI and its use for neutropenic fever is warranted.
Background:
We investigated an increase in Clostridium difficile infection (CDI) among pediatric oncology patients.
Methods:
CDI cases were defined as first C difficile positive stool tests between December 1, 2010, and September 6, 2012, in pediatric oncology patients receiving inpatient or outpatient care at a single hospital. A case-control study was performed to identify CDI risk factors, infection prevention and antimicrobial prescribing practices were assessed, and environmental sampling was conducted. Available isolates were strain-typed by pulsed-field gel electrophoresis.
Results:
An increase in hospital-onset CDI cases was observed from June-August 2012. Independent risk factors for CDI included hospitalization in the bone marrow transplant ward and exposure to computerized tomography scanning or cefepime in the prior 12 weeks. Cefepime use increased beginning in late 2011, reflecting a practice change for patients with neutropenic fever. There were 13 distinct strain types among 22 available isolates. Hospital-onset CDI rates decreased to near-baseline levels with enhanced infection prevention measures, including environmental cleaning and prolonged contact isolation.
Conclusion:
C difficile strain diversity associated with a cluster of CDI among pediatric oncology patients suggests a need for greater understanding of modes and sources of transmission and strategies to reduce patient susceptibility to CDI. Further research is needed on the risk of CDI with cefepime and its use as primary empirical treatment for neutropenic fever.
More Related Videos
09:12A Protein Microarray Assay for Serological Determination of Antigen-specific Antibody Responses Following Clostridium difficile Infection
Published on: June 15, 2018
12:58A Protocol to Characterize the Morphological Changes of Clostridium difficile in Response to Antibiotic Treatment
Published on: May 25, 2017
