Fluoroquinolones tied with Higher Pediatric C Difficile Hospitalization Rate: Study

Clostridioides difficile, formerly known as Clostridium difficile, is a Gram-positive, spore-forming, anaerobic bacillus, which can exist both in toxigenic and non-toxigenic form. It is transmitted through the fecal–oral route or by direct contact. C. difficile is responsible for healthcare-associated diarrhea, but it is more common in adult with high mortality in elderly patients. Instead, C. difficile colonization is more frequent in the pediatric population, where most are asymptomatic. One major explanation is the absence of toxin-binding receptors in the immature intestinal mucosa of children In recent years, the colonization rate has also increased in the pediatric population, even in the community setting. While there are numerous studies regarding Clostridioides difficile infection (CDI) in adults, literature on the pediatric population is scarce.

Therefore, researchers performed a 5-year retrospective study between January 2014 and December 2018 in two referral centers in Rome, Italy. There were 359 patients tested for CDI who were enrolled: 87 resulted in positive and 272 in negative.

The results of the study are:

• CDI children had a higher number of previous-day hospital admissions (p = 0.024), hospitalizations (p = 0.001), and total hospital admissions (p = 0.008).
• Chronic comorbidities were more frequent in the CDI group (66.7% vs. 33.3%). Previous use of proton pump inhibitors and antibiotics was associated with CDI (p < 0.001).
• Among the antibiotics, only fluoroquinolones were significantly associated with CDI. Also, CDI children were more frequently exposed to antibiotics during the episode of hospitalization when children were tested.

Thus, the researchers concluded that this study provides an updated clinical and epidemiological analysis of children with CDI compared with a control group of children who tested negative. Further prospective studies could better define risk factors and preventive methods.

Reference:

Clostridioides difficile Infection in Children: A 5-Year Multicenter Retrospective Study by Danilo Buonsenso et al. published in the Frontiers in Pediatrics.

https://doi.org/10.3389/fped.2022.783098

Keywords:

Danilo Buonsenso, Rosalia Graffeo4, Davide Pata, Piero Valentini, Carla Palumbo, Luca Masucci, Antonio Ruggiero, Giorgio Attinà, Manuela Onori, Laura Lancella, Barbara Lucignano, Martina Di Giuseppe, Paola Bernaschi8 and Laura Cursi, Clostridioides, difficile, Infection, Children, 5-Year Multicenter, Retrospective, Study, Frontiers in Pediatrics.