Risk factors for community-associated Clostridioides difficile infection in young children

Details

• Alternative Title:
  Epidemiol Infect
• Personal Author:
  Weng, M. K. ; Adkins, S. H. ; Bamberg, W. ; Farley, M. M. ; Espinosa, C. C. ; Wilson, L. ; Perlmutter, R. ; Holzbauer, S. ; Whitten, T. ; Phipps, E. C. ; Hancock, E. B. ; Dumyati, G. ; Nelson, D. S. ; Beldavs, Z. G. ; Ocampo, V. ; Davis, C. M. ; Rue, B. ; Korhonen, L. ; McDonald, L. C. ; Guh, A. Y.
• Description:
  The majority of paediatric Clostridioides difficile infections (CDI) are community-associated (CA), but few data exist regarding associated risk factors. We conducted a case-control study to evaluate CA-CDI risk factors in young children. Participants were enrolled from eight US sites during October 2014-February 2016. Case-patients were defined as children aged 1-5 years with a positive C. difficile specimen collected as an outpatient or ⩽3 days of hospital admission, who had no healthcare facility admission in the prior 12 weeks and no history of CDI. Each case-patient was matched to one control. Caregivers were interviewed regarding relevant exposures. Multivariable conditional logistic regression was performed. Of 68 pairs, 44.1% were female. More case-patients than controls had a comorbidity (33.3% vs. 12.1%; P = 0.01); recent higher-risk outpatient exposures (34.9% vs. 17.7%; P = 0.03); recent antibiotic use (54.4% vs. 19.4%; P < 0.0001); or recent exposure to a household member with diarrhoea (41.3% vs. 21.5%; P = 0.04). In multivariable analysis, antibiotic exposure in the preceding 12 weeks was significantly associated with CA-CDI (adjusted matched odds ratio, 6.25; 95% CI 2.18-17.96). Improved antibiotic prescribing might reduce CA-CDI in this population. Further evaluation of the potential role of outpatient healthcare and household exposures in C. difficile transmission is needed.
• Subjects:
  Clostridium Difficile Original Paper
• Source:
  Epidemiol Infect. 2019; 147
• Pubmed ID:
  31063097
• Pubmed Central ID:
  PMC6518485
• Document Type:
  Journal Article
• Volume:
  147
• Collection(s):
  CDC Public Access
• Main Document Checksum:
  urn:sha256:0fc9a8dcff3d41c4b751b9edbba85db04df1bd5e798e68bc4c634b83ff96518a
• Download URL:
  https://stacks.cdc.gov/view/cdc/81509/cdc_81509_DS1.pdf
• File Type:
  [PDF - 156.03 KB ]