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Updated: Jun 1, 2026
A Protocol to Characterize the Morphological Changes of Clostridium difficile in Response to Antibiotic Treatment
Published on: May 25, 2017
Age-related clinical and therapeutic differences during a hospital outbreak of Clostridioides difficile infection in
Andrés Arias-Sánchez1, Stephanie Casadiego-Payares2, Camilo Acosta-Parada1
1Hospital Universitario Erasmo Meoz, Infectoped Research Group (IRG), Cúcuta, Colombia; Infectoped Research Group (IRG), Cúcuta, Colombia.
Insights
Children were disproportionately affected during a hospital-acquired Clostridioides difficile infection (HA-CDI) outbreak in Colombia. Pediatric patients experienced earlier symptom onset and received longer treatment durations, highlighting the need for age-specific HA-CDI strategies.
Area of Science:
- Infectious Diseases
- Pediatrics
- Epidemiology
Background:
- Limited pediatric data exists on hospital-acquired Clostridioides difficile infection (HA-CDI) outbreaks in Latin America.
- This study investigated age-related differences during a HA-CDI outbreak in Colombia.
Purpose of the Study:
- To compare clinical, microbiological, therapeutic, and outcome differences between pediatric and adult patients during a HA-CDI outbreak.
- To inform age-stratified surveillance and management strategies for HA-CDI.
Main Methods:
- A retrospective observational study was conducted during a HA-CDI outbreak (September 2017-March 2018) at a tertiary-care hospital in Medellín, Colombia.
- Cases were identified based on compatible diarrhea and positive C. difficile toxin gene detection via real-time PCR.
Main Results:
- Fifteen of 25 (60%) identified HA-CDI cases occurred in children, who presented with earlier symptom onset (median 6 vs. 13 days) and more frequent fever and tachycardia.
- Clostridioides difficile ribotype 027 was identified in one severe pediatric case.
- Children received longer treatment courses (86.7% vs. 40.0%), with similar diarrhea duration and no CDI-attributable mortality.
Conclusions:
- Pediatric predominance may be linked to age-related host-microbiota dynamics, colonization, antibiotic exposure, and diagnostic practices.
- The findings support age-stratified HA-CDI surveillance, diagnostic and antimicrobial stewardship, and tailored infection prevention strategies.
Background:
Pediatric data on hospital-acquired Clostridioides difficile infection (HA-CDI) outbreaks in Latin America are scarce. We compared age-related clinical, microbiological, therapeutic, and outcome differences during a Colombian HA-CDI outbreak.
Methods:
We conducted a retrospective observational study at a 610-bed tertiary-care hospital in Medellín, Colombia, during an epidemiologically characterized HA-CDI outbreak (September 2017-March 2018). Cases required compatible diarrhea and real-time polymerase chain reaction detection of C difficile toxin genes.
Results:
Twenty-five HA-CDI cases were identified; 15 (60%) occurred in children. Children developed symptoms earlier after admission than adults (median 6 vs 13 days) and more often presented with fever and tachycardia. Molecular characterization identified C difficile ribotype 027, corresponding to the 027/NAP1/BI lineage, in 1 pediatric severe case. Ten-day treatment regimens were more frequent in children than adults (86.7% vs 40.0%; P = .01), while diarrhea duration was similar. One pediatric recurrence occurred; no CDI-attributable mortality was observed.
Discussion:
Pediatric predominance may reflect age-related host-microbiota dynamics, colonization patterns, antibiotic exposure, and diagnostic ascertainment. Treatment findings represent local practice, not comparative effectiveness.
Conclusions:
This outbreak supports age-stratified HA-CDI surveillance, diagnostic stewardship, molecular surveillance, pediatric-adapted antimicrobial stewardship, and locally adapted infection-prevention strategies.
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