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Risk factors for the development of Clostridium difficile infection in hospitalized children

Samady, Waheedaa,b; Pong, Alicec,d; Fisher, Erind,e

doi: 10.1097/MOP.0000000000000126
GASTROENTEROLOGY AND NUTRITION: Edited by Robert Wyllie

Purpose of review This article defines the risk factors for Clostridium difficile infection (CDI) in hospitalized children in light of recent studies demonstrating a change in the epidemiology of these infections in both adults and children.

Recent findings Antibiotic exposure within the past 4–12 weeks was noted in a majority of published cases of pediatric CDI, and that remains a key risk factor for infection. Past and/or prolonged hospitalization increase a child’s risk for CDI as they increase potential contact with C. difficile spores. Of all CDI, hospital-acquired infection remains more common. Many comorbid conditions have been linked with CDI, with the strongest association existing in children with cancer and inflammatory bowel disease. Severe infections occur infrequently in pediatric patients. Markers established in adults for severe CDI resulting in colectomy or transfer to ICU have not been shown to correlate in pediatric patients.

Summary Recent antibiotic exposure and hospitalization remain key risk factors for CDI in the hospitalized pediatric patient. Patients with comorbid conditions such as malignancy and inflammatory bowel disease are at higher risk for CDI. Resistant infections and severe outcomes are not common in the pediatric population.

aFeinberg School of Medicine, Northwestern University

bAnn and Robert H. Lurie Children’s Hospital, Chicago, Illinois

cDivision of Infectious Diseases, University of California

dRady Children's Hospital

eDivision of Hospital Medicine, University of California, San Diego, California, USA

Correspondence to Waheeda Samady, Lurie Children's Hospital, 225 East Chicago Ave, Box # 55 Chicago, IL 60611, USA. Tel: +1 858 254 6988; fax: +1 312 227 9418; e-mail: wsamady@luriechildrens.org

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