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J Pediatr Surg. 2012 Jul;47(7):1385-9. doi: 10.1016/j.jpedsurg.2011.12.001.

Clostridium difficile infection in the pediatric surgery population.

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  • 1Department of Surgery, University of Minnesota, Amplatz Children's Hospital, Minneapolis, MN 55455, USA. Kathryn.chen@gmail.com

Abstract

PURPOSE:

The incidence of Clostridium difficile-associated disease (CDAD) in the adult population doubled in the past decade, with increasing morbidity and mortality; however, little research has been performed in the pediatric population. We characterized C difficile infection in the pediatric population, with emphasis on the surgical population.

METHODS:

At a university-based children's hospital, we reviewed 231 patient (birth to 18 years of age) records containing a diagnosis of CDAD between January 1, 2002, and December 31, 2008.

RESULTS:

Clostridium difficile-associated disease incidence increased from 250 per 100,000 hospitalizations in 2002 to 580 per 100,000 hospitalizations in 2008. No fatalities or surgical interventions were attributable to CDAD. Eighty-seven percent of patients received antibiotics within 2 months of diagnosis. Fifty-two percent of patients underwent operative intervention within 2 months of diagnosis; of these, 89% percent received previous antibiotic therapy and 57% were immunosuppressed. The most common antecedent procedures were bone marrow biopsy and line placement for myelodysplastic diseases (40%), followed by renal transplant (11%).

CONCLUSIONS:

Pediatric CDAD incidence doubled during the study period but was not associated with death or operative intervention. A substantial number of CDAD cases were associated with previous operative procedures, particularly in immunosuppressed patients and those who received prior antibiotics.

Copyright © 2012 Elsevier Inc. All rights reserved.

PMID:
22813801
[PubMed - indexed for MEDLINE]
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