title: Clostridium difficile infection in newly diagnosed pediatric patients with inflammatory bowel disease: prevalence and risk factors.
abstract: BACKGROUND
  Epidemiological and microbiological data suggest that Clostridium difficile infection (CDI) plays a substantial role in the clinical initiation of inflammatory bowel disease (IBD). The aim of the present study was to investigate the prevalence and risk factors of CDI in newly diagnosed pediatric patients with IBD.
  
  
  METHODS
  The current investigation was a retrospective study. All patients newly diagnosed with IBD in the pediatric gastroenterology clinic in Warsaw between 2007 and 2010 were included in the present study. The patients were diagnosed according to Porto criteria and microbiology evaluation screening tests for CDI were conducted. Risk factors including prior hospitalization, use of antibiotics within 2 months of CDI detection, colonic involvement, and the duration of symptoms were evaluated. CDI diagnosis was based on a positive stool enzyme immunoassay.
  
  
  RESULTS
  In the present study, 134 patients were evaluated (54 patients with Crohn's disease, and 80 with ulcerative colitis; 87% of the patients had colonic disease). The average age of the patients was 12.3 years, and the prevalence of CDI was 47% (95% confidence interval [CI], 38%-56%). Significant differences in the prevalence of CDI between patients with Crohn's disease and ulcerative colitis (P = 0.72; odds ratio [OR] = 1.187, 95% CI, 0.56-2.52) were not observed. The risk of CDI was associated with an increase in the age of the patient and the severity of the disease.
  
  
  CONCLUSIONS
  The prevalence of CDI in newly diagnosed IBD patients was high and was independent of the type of disease.
authors.affiliation: Department of Pediatric Gastroenterology and Nutrition, Medical University of Warsaw, Poland. aleksandra.banaszkiewicz@gmail.com
authors.forename: Aleksandra
authors.initials: A
authors.lastname: Banaszkiewicz
authors.forename: Kinga
authors.initials: K
authors.lastname: Kowalska-Duplaga
authors.forename: Tomasz
authors.initials: T
authors.lastname: Pytrus
authors.forename: Hanna
authors.initials: H
authors.lastname: Pituch
authors.forename: Andrzej
authors.initials: A
authors.lastname: Radzikowski
mesh_terms: D000293:Adolescent; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D002648:Child; D002675:Child, Preschool; D016360:Clostridioides difficile / Q000302:isolation & purification*; D003015:Clostridium Infections / Q000188:drug therapy / Q000453:epidemiology* / Q000382:microbiology*; D003093:Colitis, Ulcerative / Q000175:diagnosis / Q000382:microbiology*; D003424:Crohn Disease / Q000175:diagnosis / Q000382:microbiology*; D005260:Female; D005500:Follow-Up Studies; D006760:Hospitalization; D006801:Humans; D007223:Infant; D008297:Male; D016017:Odds Ratio; D015995:Prevalence; D011379:Prognosis; D012189:Retrospective Studies; D012307:Risk Factors
chemical_list: D000900:Anti-Bacterial Agents