Related Experiment Video
Updated: Dec 12, 2025
Fecal Microbiota Transplantation via Colonoscopy for Recurrent C. difficile Infection
Published on: December 8, 2014
Clostridioides difficile Infections in Inpatient Pediatric Oncology Patients: A Cohort Study Evaluating Risk Factors
Daniel N Willis1, Frederick S Huang1, Alexis M Elward2
1Division of Pediatric Hematology/Oncology, Washington University School of Medicine, St Louis, Missouri, USA.
Insights
Clostridioides difficile infection (CDI) in pediatric cancer patients significantly lengthens hospital stays and delays chemotherapy. Identifying risk factors like prior antibiotics and co-admission is crucial for improving care.
Area of Science:
- Pediatric Oncology
- Infectious Diseases
- Hospital Epidemiology
Background:
- Clostridioides difficile infection (CDI) is a major cause of illness in pediatric cancer patients.
- Limited data exists on risk factors and outcomes for this vulnerable population.
Purpose of the Study:
- To investigate the prevalence of CDI in pediatric oncology admissions.
- To identify associated risk factors for CDI.
- To evaluate short-term outcomes of CDI, including length of stay and chemotherapy delays.
Main Methods:
- Retrospective review of pediatric oncology admissions from 2009-2018.
- Identification of initial Clostridioides difficile infection (CDI) cases.
- Analysis of risk factors including co-admission, prior antibiotic exposure, and medication use.
- Evaluation of length of stay and chemotherapy delays.
Main Results:
- 11.4% of patients developed CDI.
- Leukemia/lymphoma, autologous hematopoietic stem cell transplant (HSCT), and prior antibiotic exposure were significant risk factors.
- Concurrent admission with another CDI patient dramatically increased risk (OR 84.7).
- Acid-suppressing medication exposure showed a protective effect (OR 0.5).
- CDI increased length of stay by 8 days and delayed chemotherapy by 1.4 days.
Conclusions:
- CDI significantly impacts pediatric cancer patients by prolonging hospitalization and delaying critical chemotherapy.
- Controlling CDI is essential for optimizing the care and treatment of pediatric oncology patients.
Background:
Clostridioides difficile infection (CDI) is a significant source of morbidity in pediatric cancer patients. Few reports to date have evaluated risk factors and short-term outcomes for this population.
Methods:
We retrospectively evaluated pediatric oncology admissions at St Louis Children's Hospital from 2009 to 2018. All inpatient cases of diagnosed initial CDI were identified. We aimed to investigate the prevalence of CDI and associated risk factors, including coadmission with another patient with CDI, and to evaluate short-term outcomes including length of stay and delays in subsequent scheduled chemotherapy.
Results:
Review of 6567 admissions from 952 patients revealed 109 CDI cases (11.4% of patients). Patients with leukemia or lymphoma, compared to those with solid tumors, were more likely to have CDI (odds ratio [OR], 3 [95% CI, 1.4-6.6], and 3 [95% CI, 1.3-6.8], respectively). Autologous hematopoietic stem cell transplant (HSCT) was also a risk factor (OR, 3.5 [95% CI, 1.7-7.4]). Prior antibiotic exposure independently increased the risk for CDI (OR, 3.0 [95% CI, 1.8-4.8]). Concurrent admission with another patient with CDI also significantly increased the risk (OR, 84.7 [95% CI, 10.5-681.8]). In contrast to previous reports, exposure to acid-suppressing medications decreased the risk for CDI (OR, 0.5 [95% CI, .3-.7]). CDI was associated with increased length of stay (mean difference, 8 days [95% CI, 4.6-11.4]) and prolonged delays for subsequent chemotherapy (mean difference, 1.4 days [95% CI, .1-2.7]).
Conclusions:
CDI in pediatric oncology patients significantly prolongs hospitalization and delays chemotherapy treatment plans. Interventions to control CDI will improve the care of pediatric oncology patients.
Related Concept Videos
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...
01:22Healthcare Associated Infections II: Preventive Measures
The best practices for preventing healthcare-associated infections include hand hygiene, patient risk...
01:23Pharmacokinetics in Pediatric Patients: Overview and Drug Absorption
01:17Pharmacokinetics in Pediatric Patients: Drug Distribution
01:26Healthcare Associated Infections I: Iatrogenic, Exogenic and Endogenic
HAIs significantly increase the cost of health care. Extended stays in healthcare institutions, increased disability, increased costs of medications, including specialized antibiotics, and prolonged recovery times add to the patient's expenses and the healthcare institution and funding bodies.
01:26Pharmacokinetics in Pediatric Patients: Drug Excretion