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http://dx.doi.org/10.5223/kjpgn.2010.13.2.146

Epidemiology and Clinical Characteristics of Clostridium difficile-associated Disease in Children: Comparison between Community- and Hospital-acquired Infections  

Cho, Hye-Jung (Department of Pediatrics, Graduate School of Medicine, Gachon University of Medicine and Science)
Ryoo, Eell (Department of Pediatrics, Graduate School of Medicine, Gachon University of Medicine and Science)
Sun, Yong-Han (Department of Pediatrics, Graduate School of Medicine, Gachon University of Medicine and Science)
Cho, Kang-Ho (Department of Pediatrics, Graduate School of Medicine, Gachon University of Medicine and Science)
Son, Dong-Woo (Department of Pediatrics, Graduate School of Medicine, Gachon University of Medicine and Science)
Tchah, Hann (Department of Pediatrics, Graduate School of Medicine, Gachon University of Medicine and Science)
Publication Information
Pediatric Gastroenterology, Hepatology & Nutrition / v.13, no.2, 2010 , pp. 146-153 More about this Journal
Abstract
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${\pm}$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.
Keywords
Clostridium difficile; Children; Diarrhea; Community-acquired infections; Nosocomial infections;
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Times Cited By KSCI : 8  (Citation Analysis)
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