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Prevalence and sequelae of asymptomatic Clostridioides difficile colonization in children with inflammatory bowel

Seth A Reasoner1, Lisa S Zhang2, Rachel Bernard2

  • 1Division of Molecular Pathogenesis, Department of Pathology, Microbiology & Immunology, Vanderbilt University Medical Center, Nashville, Tennessee, USA.

Journal of Pediatric Gastroenterology and Nutrition
|December 20, 2024
PubMed

Insights

Asymptomatic Clostridioides difficile colonization is common in pediatric inflammatory bowel disease (IBD) patients. Colonized children had a higher risk of developing C. difficile infection (CDI) later.

Area of Science:

  • Pediatric Gastroenterology
  • Infectious Diseases
  • Microbiome Research

Background:

  • Clostridioides difficile colonization is frequent in pediatric inflammatory bowel disease (IBD).
  • Asymptomatic colonization complicates IBD management and CDI diagnosis.
  • Limited data exists on colonization rates, risk factors, and outcomes in this population.

Purpose of the Study:

  • To investigate the prevalence, risk factors, and outcomes of asymptomatic C. difficile colonization in children with IBD.
  • To establish baseline data for future longitudinal studies.

Main Methods:

  • Prospective follow-up of 87 children with IBD without acute gastrointestinal symptoms.
  • Screening for C. difficile colonization.
  • Univariate regression analysis for risk factors.
  • Tracking of subsequent C. difficile infection (CDI) diagnosis.

Main Results:

  • 13.8% of children (12/87) had asymptomatic C. difficile colonization.
  • Elevated white blood cell count was associated with colonization (univariate analysis).
  • 25% (3/12) of colonized children developed CDI within 90 days, versus 0% of non-colonized children (p=0.002).

Conclusions:

  • Asymptomatic C. difficile colonization is prevalent in pediatric IBD.
  • Colonization may predict future CDI development.
  • Further longitudinal monitoring of C. difficile in pediatric IBD is warranted.

Keywords:
carriageoutcomespediatrics

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