Background: Clostridium difficile infection (CDI) is the single most common cause of nosocomial diarrhea in both adults and children. There is a deficiency in the literature regarding the incidence and associated risk factors in hospitalized children. This study aimed to determine the incidence of CDI and its associated risk factors.
Methods: A retrospective study was conducted among 200 pediatric patients admitted to the pediatric ward at Hamad General Hospital (HGH) in Qatar. The study collected data from January 1, 2015 till December 2015. Univariate and multivariate logistic regression methods were used to assess each risk factor of CDI.
Results: Among the 200 patients, 23 were diagnosed with CDI (incidence: 5.9 per 1000 inpatient admission cases). The mean patient age (±SD) was 6.4 ± 3.4 years. The incidence of antibiotic exposure (22.5; 95% CI: 15.0-38.7; P <0.001), prolonged hospitalization (28.9; 95% CI: 17.1-43.3; P <0.001), and enteral feeding (33.3; 95% CI: 15.9-55.1; P <0.001) were significant risk factors for CDI.
Conclusion: Antibiotics exposure, prolonged hospitalization, and enteral feeding were significant risk factors of CDI in hospitalized children; thus, emphasizing the importance of antimicrobial stewardship programs in the prevention of hospital-associated infection. Further prospective studies are needed to assess the trend in incidence and to identify other risk factors of CDI.
Keywords: Clostridium difficile infection (CDI); antimicrobial stewardship; hospital acquired; hospitalized pediatric patients; risk factors.
© 2019 Khalil et al.
Conflict of interest statement
The authors report no conflicts of interest in this work.
Hospital Acquired Clostridium Difficile Infection in Pediatric Wards: A Retrospective Case-Control StudyA Karaaslan et al. Springerplus 5 (1), 1329. PMID 27563524.This is the first description of the incidence and associated risk factors of CDI in Turkish children. One of the most important risk factor was prior antibiotic exposure …
[Clostridium Difficile Isolation in Children Hospitalized With Diarrhea]B Santiago et al. An Pediatr (Barc) 82 (6), 417-25. PMID 25217386.The isolation of Clostridium difficile is common in hospitalized children with diarrhea in our setting. CDI is more frequent in children with comorbidity and recent conta …
Assessing the Risk and Disease Burden of Clostridium Difficile Infection Among Patients With Hospital-Acquired Pneumonia at a University Hospital in Central ChinaC Li et al. Infection 45 (5), 621-628. PMID 28497295.CDI was common among patients discharged from hospital for HAP at a university hospital. Prevention of the spreading of C. difficile among hospitalized patients is urgent …
Comparison of Pediatric and Adult Antibiotic-Associated Diarrhea and Clostridium Difficile InfectionsLV McFarland et al. World J Gastroenterol 22 (11), 3078-104. PMID 27003987. - ReviewAntibiotic-associated diarrhea (AAD) and Clostridium difficile infections (CDI) have been well studied for adult cases, but not as well in the pediatric population. Wheth …
Risk Factors for the Development of Clostridium Difficile Infection in Hospitalized ChildrenW Samady et al. Curr Opin Pediatr 26 (5), 568-72. PMID 25032717. - ReviewRecent antibiotic exposure and hospitalization remain key risk factors for CDI in the hospitalized pediatric patient. Patients with comorbid conditions such as malignancy …
- Hall IC, O’Toole EL. Intestinal flora in new-born infants: with a description of a new pathogenic anaerobe, Bacillus difficilis. Am J Dis Child. 1935;49:390–402. doi:10.1001/archpedi.1935.01970020105010 - DOI
- Dubberke ER, Gerding DN, Classen D, et al. Strategies to prevent Clostridium difficile infections in acute care hospitals. Infect Control Hosp Epidemiol. 2008;29Suppl 1:S81–92. - PubMed
- Langley JM, LeBlanc JC, Hanakowski M, et al. The role of Clostridium difficile and viruses as causes of nosocomial diarrhea in children. Infect Control Hosp Epidemiol. 2002;23:660–664. - PubMed