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Recent Issues in Pediatric Clostridium difficile Infection

Jason A Clayton1, Philip Toltzis2

  • 1Division of Pediatric Critical Care, Rainbow Babies and Children's Hospital, 11100 Euclid Avenue, Cleveland, OH, 44106, USA. jason.clayton@uhhospitals.org.

Current Infectious Disease Reports
|November 8, 2017
PubMed

Insights

Community-acquired Clostridium difficile infection (CA-CDI) is emerging in children, with up to 25% experiencing recurrent infections. New prevention strategies are being tested for pediatric recurrent CDI.

Area of Science:

  • Pediatric Infectious Diseases
  • Microbiome Research
  • Epidemiology

Background:

  • Clostridium difficile infection (CDI) is a significant concern in children.
  • Emergence of community-associated CDI (CA-CDI) and recurrent CDI are key challenges.
  • Accurate diagnosis in young children is complicated by asymptomatic C. difficile excretion.

Purpose of the Study:

  • To review recent advances in understanding community-associated CDI (CA-CDI) in children.
  • To examine the incidence and prevention strategies for recurrent CDI in pediatric populations.
  • To highlight areas for future research in pediatric CDI.

Main Methods:

  • Review of current literature and survey data on pediatric CDI.
  • Analysis of risk factors and diagnostic challenges for CA-CDI in children.
  • Evaluation of emerging preventative strategies for recurrent CDI, adapted from adult studies.

Main Results:

  • A substantial proportion of pediatric CDI cases are acquired in the community.
  • High rates of asymptomatic C. difficile excretion in infants and toddlers complicate CA-CDI estimates.
  • Recurrent CDI affects up to 25% of children diagnosed with the infection.
  • Several adult preventative strategies (e.g., microbiome therapies, immune therapies) are under investigation for pediatric use.

Conclusions:

  • Further research is needed to accurately characterize community acquisition of CDI in children.
  • Defining the safety and efficacy of recurrent CDI prevention strategies in pediatric patients is crucial.
  • Understanding asymptomatic excretion is key to managing CA-CDI in young children.
Abstract

Keywords:
Childhood diarrheaClostridium difficilePediatrics

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