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Published on: December 10, 2016
Risk factors for Clostridioides difficile infection in children: a systematic review and meta-analysis
1Provincial Centre for Clinical Laboratories, The Second Hospital of Hebei Medical University, Shijiazhuang, Hebei, China.
Insights
Clostridioides difficile infection (CDI) is a growing concern in children. Prior antibiotic use, prolonged hospitalization, and certain medical conditions significantly increase the risk of CDI in pediatric patients.
Area of Science:
- Pediatric Infectious Diseases
- Gastroenterology
- Epidemiology
Background:
- Clostridioides difficile infection (CDI) is an urgent public health threat, with increasing incidence in children.
- Both hospital-acquired and community-acquired CDI cases are rising in pediatric populations.
Approach:
- A systematic review and meta-analysis was conducted to identify risk factors for CDI in children.
- Twenty-five observational studies were included, analyzing data from inception to January 2022.
- Data were pooled using fixed or random-effects models to calculate odds ratios (OR) for various risk factors.
Key Points:
- Prior antibiotic exposure (OR 1.93) and gastric acid suppressants (OR 1.96) are associated with increased CDI risk.
- Prolonged hospitalization (OR 14.68) and history of hospitalization (OR 3.67) are significant risk factors.
- Male gender, neoplastic disease, immunodeficiency, solid organ transplantation, and enteral feeding also increase CDI susceptibility in children.
Conclusions:
- This meta-analysis confirms several key risk factors for pediatric CDI.
- Findings aim to enhance clinical awareness and guide preventative strategies for Clostridioides difficile-associated diarrhea in children.
Background:
Clostridioides difficile is considered an urgent threat to human health by the US Centers for Disease Control and Prevention. In recent years, C. difficile has been reported increasingly as a cause of gastrointestinal disease in children, and the prevalence of hospital-acquired C. difficile infection and community-acquired CDI in children is increasing.
Aim:
To perform a systematic review and meta-analysis of risk factors for CDI in children.
Methods:
MEDLINE/PubMed, EMBASE, Web of Science, Scopus, OVID, China National Knowledge Infrastructure, Wanfang (Chinese), SinoMed (Chinese) and Weipu (Chinese) were searched from inception to 12th January 2022. Observational studies (cohort, case-control and cross-sectional) on CDI in children were included in the analysis. Data were pooled using a fixed or random-effects model, and odds ratios (OR) were calculated.
Findings:
In total, 25 observational studies were included in the analysis. Prior antibiotic exposure [OR 1.93, 95% confidence interval (CI) 1.25-2.97], prolonged hospitalization (OR 14.68, 95% CI 13.24-16.28), history of hospitalization (OR 3.67, 95% CI 1.91-7.06), gastric acid suppressants (OR 1.96, 95% CI 1.41-2.73), male gender (OR 1.18, 95% CI 1.05-1.32), neoplastic disease (OR 3.40, 95% CI, 2.85-4.07), immunodeficiency (OR 4.18, 95% CI 3.25-5.37), solid organ transplantation (OR 4.56, 95% CI 3.95-5.27) and enteral feeding (OR 2.21, 95% CI 1.05-4.62) were associated with increased risk of CDI.
Conclusion:
This systematic review and meta-analysis provides further evidence for the susceptibility factors of CDI to improve clinicians' awareness of CDI, and prevent C. difficile-associated diarrhoea in children.
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