title: [Risk factors of Clostridium difficile-associated diarrhea in children].
abstract: OBJECTIVE
  To explore the risk factors of Clostridium difficile-associated diarrhea (CDAD) in children.
  
  
  METHODS
  From December 2010 to March 2011, the hospitalized diarrheal patients under 18 years old at Beijing Children's Hospital were tested for Clostridium difficile. The CDAD(+) patients were selected and their fecal specimens were PCR-positive for tcdA and (or) tcdB genes. And the patients with healthcare facility-associated-CDAD (HCFA-CDAD) were selected from the group of CDAD(+). The CDAD patients were selected and their fecal specimens were PCR-negative for tcdA and (or) tcdB genes. And the 1:3 matched controls per case were selected from those hospitalized patients without diarrhea at the same department with similar diseases during the same period. The potential predictors of CDAD included age, gender, co-morbidities, prior hospitalization, the administration of C. difficile-active antibiotics during prior 24 hours, recent (< 1 month) exposure to antibiotics or acid-blocking medications or nonsteroidal anti-inflammatory drug (NSAID), C-reactive protein (CRP) and white blood cell (WBC), etc. Multivariate Logistic regression models were created to identify the independent predictors of CDAD.
  
  
  RESULTS
  Among 93 PCR tests, 35 were positive in fecal samples. There were HCFA-CDAD (n = 30) and CDAD(-) (n = 58). Thirty-five CDAD(+) hospitalized patients were compared with 105 controls. According to multivariate analyses, the predictors of CDAD included prior hospitalization (P < 0.01, OR = 0.002), CRP(P = 0.008, OR = 3.465), NSAID (P = 0.015, OR = 13.950) and WBC (P = 0.003, OR = 8.063).
  
  
  CONCLUSIONS
  The administration of NSAID, elevated CRP and abnormal WBC are significantly associated with CDAD.
authors.affiliation: Department of Gastroenterology, Beijing Children's Hospital, Beijing, China.
authors.forename: Shu
authors.initials: S
authors.lastname: Guo
authors.forename: Xi-wei
authors.initials: XW
authors.lastname: Xu
authors.forename: Fang
authors.initials: F
authors.lastname: Dong
mesh_terms: D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000009:adverse effects; D002097:C-Reactive Protein / Q000032:analysis; D016022:Case-Control Studies; D002648:Child; D002675:Child, Preschool; D016360:Clostridioides difficile / Q000472:pathogenicity*; D003015:Clostridium Infections / Q000453:epidemiology*; D003428:Cross Infection / Q000453:epidemiology / Q000382:microbiology; D003967:Diarrhea / Q000453:epidemiology* / Q000382:microbiology*; D005243:Feces / Q000382:microbiology; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007958:Leukocyte Count; D008297:Male; D012307:Risk Factors
chemical_list: D000894:Anti-Inflammatory Agents, Non-Steroidal; D002097:C-Reactive Protein