Hospitalization With Clostridioides difficile in Pediatric Inflammatory Bowel Disease: a Population-Based Study

Area of Science:

• Pediatric Gastroenterology
• Infectious Diseases
• Epidemiology

Background:

• Adult studies indicate increased Clostridioides difficile infection (CDI) rates in inflammatory bowel disease (IBD) patients.
• The risk of CDI in pediatric IBD populations remains less understood.

Purpose of the Study:

• To compare the risk of hospitalization with CDI in children with and without IBD.
• To analyze CDI incidence rates between pediatric Crohn disease and ulcerative colitis patients.

Main Methods:

• Population-based study utilizing Canadian health administrative data for children (<16 years).
• Age and sex-matched cohort design comparing children with and without IBD.
• Incidence rates and hazard ratios calculated using generalized linear mixed-effects and Cox proportional hazards models.

Main Results:

• Children with IBD had a substantially higher incidence rate of hospitalization with CDI (49.06 per 10,000 person-years) versus those without IBD (0.39 per 10,000 person-years).
• The adjusted hazard ratio for CDI hospitalization in children with IBD was 68.2.
• CDI was identified less frequently in children with Crohn disease compared to ulcerative colitis.

Conclusions:

• Pediatric IBD patients face a markedly elevated risk of CDI during hospitalization.
• Routine screening for CDI is recommended for symptomatic children with IBD upon hospital admission.