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Clostridioides difficile in Children.

Larry K Kociolek1, Thomas J Sandora2, Preeti Mehrotra3

  • 1Department of Pediatrics, Northwestern University Feinberg School of Medicine; Division of Pediatric Infectious Diseases, Ann & Robert H. Lurie Children's Hospital of Chicago, 225 E. Chicago Avenue, Box 20, Chicago, IL 60611, USA.

Infectious Disease Clinics of North America
|August 8, 2025
PubMed
Summary
This summary is machine-generated.

Pediatric Clostridioides difficile infection (CDI) incidence is declining, with community-associated cases being more common. Vancomycin is recommended as a first-line treatment, and other therapies are effective for recurrent CDI.

Keywords:
ChildrenClostridioides difficileColonizationDiagnosisEpidemiologyInfantsPediatricTreatment

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Area of Science:

  • Pediatric Infectious Diseases
  • Microbiology
  • Gastroenterology

Background:

  • Clostridioides difficile infection (CDI) incidence in children has significantly increased over the past two decades.
  • While overall pediatric CDI incidence has declined in the last five years, community-associated CDI remains a significant concern.
  • Sources of community acquisition for pediatric CDI are not well understood, complicating diagnosis and prevention efforts.

Purpose of the Study:

  • To summarize current trends in pediatric Clostridioides difficile infection (CDI).
  • To highlight challenges in diagnosing CDI in pediatric populations.
  • To review recommended and emerging therapeutic strategies for pediatric CDI.

Main Methods:

  • Review of recent epidemiological data on pediatric CDI incidence.
  • Analysis of diagnostic challenges, including high rates of colonization in infants and children.
  • Evaluation of current and emerging treatment guidelines and clinical trial data for pediatric CDI.

Main Results:

  • Pediatric CDI incidence has declined in the past five years after a prior significant increase.
  • Community-associated CDI is more prevalent than healthcare facility-associated CDI in children.
  • Vancomycin is suggested as a first-line treatment for pediatric CDI.
  • Fidaxomicin and fecal microbiota transplantation demonstrate safety and efficacy for recurrent pediatric CDI.

Conclusions:

  • Despite a recent decline, pediatric CDI remains a critical public health issue, particularly community-associated infections.
  • Accurate diagnosis of CDI in children is complicated by high colonization rates.
  • Current evidence supports vancomycin as a primary treatment, with fidaxomicin and FMT as viable options for recurrent cases.