Epidemiologic surveillance of Clostridium difficile diarrhea in a freestanding pediatric hospital and a pediatric hospital at a university medical center

Carmen E. Rexach, Yajarayma J. Tang-Feldman, Mary C. Cantrell, Stuart H Cohen

Research output: Contribution to journalArticlepeer-review

28 Scopus citations

Abstract

To describe the epidemiology of Clostridium difficile in children, we cultured stool specimens from patients at the Children's Hospital Central California, Madera, CA (CHCC, n = 676) and at the University of California Davis Medical Center Pediatric Hospital, Sacramento, CA (UCDMC-PH, n = 301) for C. difficile, and toxins A and B genes and strain identity of the isolates were determined by polymerase chain reaction assays. A higher percentage of patients from UCDMC-PH were culture positive (148/301, 49%) and colonized with toxigenic strains (45/301, 15%) compared with CHCC (colonized = 178/676, 26%; toxigenic = 96/676, 14%, P ≤ .001). Multiple logistic regression analysis showed decreased colonization with inpatient status (odds ratio [OR] = 0.64; 95% confidence interval [CI] = 0.46, 0.89; P = .007) and use of H-2 antagonists (OR = 0.55; 95% CI = 0.36, 0.84; P = .006), whereas underlying conditions (colonization: OR = 1.42; 95% CI = 1.02, 1.96; P = .04; toxin positive: OR = 1.60; 95% CI = 1.04, 2.44; P = .03) and exposure to ≥2 antiinfectives (colonization: OR = 1.56; 95% CI = 1.10, 2.20; P = .01; toxin positive: OR = 1.71; 95% CI = 1.10, 2.66; P = .02) increased colonization. Most isolates appear to be community acquired, although molecular analysis suggests some nosocomial transmission at UCDMC-PH. These data suggest that the epidemiology of colonization with C. difficile in children is different than previously reported.

Original languageEnglish (US)
Pages (from-to)109-114
Number of pages6
JournalDiagnostic Microbiology and Infectious Disease
Volume56
Issue number2
DOIs
StatePublished - Oct 2006

Keywords

  • Clostridium difficile
  • Diarrhea
  • Epidemiology
  • Infectious disease
  • Pediatrics

ASJC Scopus subject areas

  • Infectious Diseases
  • Immunology and Allergy
  • Virology
  • Parasitology
  • Microbiology
  • Immunology
  • Applied Microbiology and Biotechnology

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