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KMID : 0816120100130020146
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Korean Journal of Pediatric Gastroenterolology and Nutrition
2010 Volume.13 No. 2 p.146 ~ p.153
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Epidemiology and Clinical Characteristics of Clostridium difficile-associated Disease in Children: Comparison between Community- and Hospital-acquired Infections
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Cho Hye-Jung
Ryoo Eell
Sun Yong-Han
Cho Kang-Ho
Son Dong-Woo
Tchah Hann
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Abstract
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Purpose: Recent studies have reported an increase in the incidence of community-acquired Clostridium difficile-associated disease (CA-CDAD) among children. There is an overall lack of information on CA-CDAD in the pediatric population. The aim of our study was to compare the epidemiologic and clinical features between CA-CDAD and hospital-acquired C. difficile-associated disease (HA-CDAD) in children.
Methods: We retrospectively reviewed the medical records of all patients who were diagnosed with C. difficile-associated disease (CDAD) at Gil Hospital between April 2008 and March 2009. The diagnosis of CDAD was made when patients with gastrointestinal symptoms had positive results for C. difficile toxins A and B assay or stool culture.
Results: Sixty-one (male, 32 and female, 29) patients were included. The mean age was 3.79±4.54 years. Of the 61 patients, 22 (36.1%) were ＜1 year of age. Twenty-three patients (37.7%) had a history of antibiotic exposure in the previous 3 months. Forty-one patients (67.2%) were diagnosed with CA-CDAD. There were no significant differences in age, gender, symptoms, laboratory findings, recovery period, complications, and recurrence between the CA-CDAD and HA-CDAD groups. On the other hand, exposure to antibiotics was significantly more frequent among patients in the HA-CDAD group (p=0.005).
Conclusion: This study suggests that the occurrence of CA-CDAD is increasing in the pediatric population, especially in younger children with no history of exposure to antibiotics and in outpatients. Awareness of the increasing incidence of CA-CDAD and prompt investigation of C. difficile in susceptible patients is needed to avoid misdiagnosis and for appropriate therapy.
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KEYWORD
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Clostridium difficile, Children, Diarrhea, Community-acquired infections, Nosocomial infections
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