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Clostridioides difficile Infection in a Japanese Tertiary Children's Hospital
Mariko Meguro1, Ryusuke Nambu1, Tomoko Hara1
1Division of Gastroenterology and Hepatology, Saitama Children's Medical Center, Saitama, Japan.
Insights
Pediatric Clostridioides difficile infection (CDI) is rising. This study highlights key patient factors like underlying conditions and antibiotic history, crucial for diagnosing and managing pediatric CDI effectively.
Area of Science:
- Pediatric Infectious Diseases
- Gastroenterology
- Microbiology
Background:
- Clostridioides difficile infection (CDI) causes enteritis and diarrhea.
- Pediatric CDI cases are increasing, but clinical management remains unclear.
- Understanding pediatric CDI patient characteristics and prognosis is essential.
Purpose of the Study:
- Elucidate the background and clinical course of pediatric CDI patients.
- Evaluate the reliability of diagnostic tests for pediatric CDI.
- Provide insights for managing CDI in children at a tertiary pediatric hospital in Japan.
Main Methods:
- Retrospective analysis of clinical data from pediatric CDI patients.
- Study period: 2011-2021 at Saitama Children's Medical Center, Japan.
- Included analysis of 1,252 C. difficile antigen/toxin tests.
Main Results:
- 37 pediatric patients diagnosed with CDI.
- Common underlying conditions: hematological, malignant, and gastrointestinal diseases (including IBD).
- Most patients were immunocompromised (73.0%) and had recent antibiotic use (67.6%).
Conclusions:
- Pediatric CDI is an increasing concern.
- Comprehensive patient history (underlying diseases, antibiotic use) is vital for diagnosis.
- Understanding clinical examination features aids in appropriate CDI diagnosis and treatment.
Purpose:
Toxins produced by Clostridioides difficile infection (CDI) can cause enteritis and diarrhea. Although the number of pediatric CDI cases is increasing, the clinical management of pediatric CDI, including patient characteristics and prognosis, remains unclear. This study aimed to elucidate the background and clinical course of patients with CDI and evaluate the reliability of diagnostic tests in a tertiary pediatric hospital in Japan.
Methods:
We retrospectively analyzed the clinical data of children diagnosed with CDI between 2011 and 2021 at the Saitama Children's Medical Center in Saitama, Japan.
Results:
During the study period, 1,252 C. difficile antigen/toxin tests were performed, and 37 patients were diagnosed with CDI. The main underlying diseases among the patients were hematological and malignant disorders and gastrointestinal diseases, including inflammatory bowel disease (IBD) (59.4%). Two patients (5.4%) had an unremarkable medical history. Among the 37 patients, 27 (73.0%) were immunocompromised, 25 (67.6%) had a history of antibiotic use within the past two months, and 6 (16.2%) were negative on the initial test but were positive on the second test. Finally, 28 patients (75.7%) required primary antibiotic therapy only, and two patients with IBD required additional antibiotic therapy as secondary treatment.
Conclusion:
The number of pediatric patients with CDI is increasing. Both a comprehensive interview, including underlying diseases and history of antibiotic use, and an understanding of the features of clinical examinations should be emphasized to appropriately diagnose and treat CDI.
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