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Clinical Significance of Clostridium difficile in Children Less Than 2 Years Old: A Case-Control Study

Marcela González-Del Vecchio1, Ana Álvarez-Uria, Mercedes Marin

  • 1From the *Department of Clinical Microbiology and Infectious Diseases, Hospital General Universitario Gregorio Marañón, Madrid, Spain; †Facultad de Medicina, Universidad Complutense de Madrid (UCM), Madrid, Spain; ‡Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain; and §CIBER de Enfermedades Respiratorias (CIBERES CD06/06/0058), Madrid, Spain.

The Pediatric Infectious Disease Journal
|December 10, 2015
PubMed

Insights

Clostridium difficile (CD) infection in infants under two years old appears insignificant, with no difference in outcomes whether treated with antibiotics or not. This suggests current antibiotic use for CD in this age group may be unnecessary.

Area of Science:

  • Pediatric Infectious Diseases
  • Microbiology
  • Gastroenterology

Background:

  • The clinical significance of Clostridium difficile (CD) in young children (≤2 years) remains poorly understood.
  • This study aimed to identify risk factors and clinical outcomes in diarrheic infants with or without CD.

Purpose of the Study:

  • To investigate risk factors associated with Clostridium difficile in infants.
  • To analyze the clinical evolution of diarrheic children under two years old with and without CD.

Main Methods:

  • A case-control study involving 100 diarrheic children with CD and 100 controls without CD, aged ≤2 years.
  • Stool samples were screened for toxigenic CD.
  • Demographic data, clinical history, and treatment were compared between groups.

Main Results:

  • No significant differences were observed between children with and without CD.
  • Infants treated with metronidazole had higher rates of gastric acid suppressant use and recent surgery.
  • All infants, regardless of metronidazole treatment, recovered from diarrhea; ribotype 014 was most common.

Conclusions:

  • Clostridium difficile appears to have minimal significance in neonates and infants under two years old.
  • Current clinical practices may lead to unnecessary antibiotic use for CD in this population.
  • Further evidence is needed to support antibiotic treatment for CD in infants.
Abstract

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