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Risk factors for community-associated Clostridioides difficile infection in young children

M K Weng1, S H Adkins1, W Bamberg2

  • 1Division of Healthcare Quality Promotion,Centers for Disease Control and Prevention,Atlanta, GA,USA.

Epidemiology and Infection
|May 8, 2019
PubMed

Insights

Community-associated Clostridioides difficile infections (CA-CDI) in young children are often linked to recent antibiotic use. This study identified antibiotic exposure as a significant risk factor, suggesting improved prescribing could reduce CA-CDI incidence.

Area of Science:

  • Pediatric Infectious Diseases
  • Microbiology
  • Epidemiology

Background:

  • Community-associated Clostridioides difficile infections (CA-CDI) are common in children, yet risk factors remain understudied.
  • Understanding CA-CDI risk factors in pediatric populations is crucial for targeted prevention strategies.

Purpose of the Study:

  • To identify risk factors associated with community-associated Clostridioides difficile infections (CA-CDI) in children aged 1-5 years.
  • To evaluate the role of recent exposures, including antibiotic use and household contacts, in pediatric CA-CDI.

Main Methods:

  • A case-control study was conducted with 68 matched pairs of children aged 1-5 years.
  • Case-patients had confirmed C. difficile infection acquired in the community or early in hospitalization.
  • Caregiver interviews and multivariable conditional logistic regression were used to analyze risk factors.

Main Results:

  • Children with CA-CDI were more likely to have comorbidities, recent outpatient exposures, and household contact with diarrhea.
  • Recent antibiotic use within the preceding 12 weeks was strongly associated with CA-CDI (aOR, 6.25).
  • A significant association was found between CA-CDI and recent antibiotic exposure.

Conclusions:

  • Antibiotic exposure is a significant risk factor for community-associated Clostridioides difficile infections in young children.
  • Optimizing antibiotic prescribing practices may decrease the incidence of CA-CDI in this vulnerable population.
  • Further research is needed on outpatient healthcare and household exposures in C. difficile transmission.

Keywords:
Clostridium difficile

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