Impact of Clostridium difficile infection on pediatric appendicitis

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Felix Orelaru1, Patrick Karabon2, Nathan Novotny2,3

  • 1St. Joseph Mercy Hospital, Ann Arbor, MI, US.

Pediatric Surgery International
|April 8, 2021
PubMed

Insights

Clostridium difficile infection rarely complicates pediatric appendicitis but significantly increases disease severity. Optimizing antibiotic use may reduce this risk in children with appendicitis.

Area of Science:

  • Pediatric Infectious Diseases
  • Gastrointestinal Surgery
  • Healthcare Epidemiology

Background:

  • Clostridium difficile infection (CDI) is a significant cause of hospital-acquired infections in children.
  • Pediatric appendicitis is a common surgical condition requiring prompt management.

Purpose of the Study:

  • To determine the incidence and impact of CDI in pediatric acute appendicitis cases.
  • To identify risk factors associated with CDI in this patient population.

Main Methods:

  • Analysis of the 2009 and 2012 Kids' Inpatient Database.
  • Weighted statistical analysis using SAS 9.4 Survey Sampling and Analysis procedures.
  • Identification of 176,934 pediatric appendicitis cases.

Main Results:

  • 0.2% of pediatric appendicitis cases had a concurrent CDI diagnosis.
  • CDI was more prevalent in perforated appendicitis (0.39%) versus non-perforated (0.06%).
  • Perforated appendicitis and anemia were independent predictors of CDI. CDI cases had longer length of stay and higher total charges.

Conclusions:

  • CDI is an uncommon but severe complication of pediatric appendicitis.
  • Increased disease severity, length of stay, and costs are associated with CDI in pediatric appendicitis.
  • Judicious antibiotic stewardship is recommended to mitigate CDI risk in pediatric appendicitis.
Abstract

Keywords:
AntibioticsAppendicitisClostridium difficileStewardship

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