title: Viral co-infections are common and are associated with higher bacterial burden in children with clostridium difficile infection.
abstract: Clostridium difficile infections in children are increasing. In this cohort study, we enrolled 62 children with diarrhea and C difficile. We performed polymerase chain reaction assays to detect viral agents of gastroenteritis and quantify C difficile burden. Fifteen (24%) children diagnosed as having C difficile infection had a concomitant viral co-infection. These patients tended to be younger and had a higher C difficile bacterial burden than children with no viral co-infections (median difference = 565,957 cfu/mL; P = 0.011), but were clinically indistinguishable. The contribution of viral co-infection to C difficile disease in children warrants future investigation.
authors.affiliation: Departments of Pediatrics, Washington University School of Medicine, St Louis, MO.
authors.forename: Rana E
authors.initials: RE
authors.lastname: El Feghaly
authors.forename: Jennifer L
authors.initials: JL
authors.lastname: Stauber
authors.forename: Phillip I
authors.initials: PI
authors.lastname: Tarr
authors.forename: David B
authors.initials: DB
authors.lastname: Haslam
mesh_terms: D000293:Adolescent; D000367:Age Factors; D058491:Bacterial Load; D002648:Child; D002675:Child, Preschool; D016360:Clostridioides difficile; D003015:Clostridium Infections / Q000150:complications* / Q000382:microbiology; D015331:Cohort Studies; D060085:Coinfection / Q000453:epidemiology* / Q000382:microbiology / Q000821:virology; D003967:Diarrhea / Q000209:etiology* / Q000382:microbiology / Q000821:virology; D005260:Female; D005759:Gastroenteritis / Q000209:etiology* / Q000382:microbiology / Q000821:virology; D006801:Humans; D008297:Male; D015995:Prevalence; D014777:Virus Diseases / Q000150:complications* / Q000453:epidemiology / Q000821:virology