Clostridioides difficile Infection in Children: A 5-Year Multicenter Retrospective Study

Area of Science:

• Pediatric Infectious Diseases
• Epidemiology
• Gastroenterology

Background:

• Clostridioides difficile infection (CDI) research predominantly focuses on adults, with limited data on pediatric cases.
• Understanding pediatric CDI epidemiology is crucial for targeted prevention and treatment strategies.

Purpose of the Study:

• To conduct a clinical and epidemiological analysis of pediatric Clostridioides difficile infection.
• To identify risk factors associated with CDI in children.

Main Methods:

• Retrospective study conducted over 5 years (January 2014 - December 2018) in two Italian referral centers.
• Analysis of 359 pediatric patients tested for CDI, comparing 87 positive cases with 272 negative controls.
• Statistical analysis to identify significant differences in demographics, comorbidities, and prior medication use.

Main Results:

• Children with CDI exhibited significantly higher rates of previous-day hospital admissions, hospitalizations, and total admissions compared to controls.
• Chronic comorbidities were more prevalent in the CDI group (66.7% vs. 33.3%).
• Previous use of proton pump inhibitors and antibiotics (specifically fluoroquinolones) was strongly associated with CDI (p < 0.001).

Conclusions:

• Pediatric CDI is associated with increased healthcare utilization and specific risk factors including comorbidities and prior medication exposure.
• Fluoroquinolone use and proton pump inhibitor use are significant risk factors for CDI in children.
• Further prospective studies are recommended to refine risk factor identification and develop preventive measures for pediatric CDI.