Clostridium difficile infection in the pediatric surgery population

Kathryn T. Chen, Daniel J. Stephens, Eric Anderson, Robert Acton, Daniel Saltzman, Donavon J. Hess

Research output: Contribution to journalArticlepeer-review

7 Scopus citations

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.

Original languageEnglish (US)
Pages (from-to)1385-1389
Number of pages5
JournalJournal of Pediatric Surgery
Volume47
Issue number7
DOIs
StatePublished - Jul 2012

Keywords

  • CDAD
  • Clostridium difficile
  • Enterocolitis
  • Immunosuppression
  • Surgical complications

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