title: [Clinic and epidemiologic description of Clostridium difficile infection in a pediatric population].
abstract: BACKGROUND
  Clostridium difficile (CUj-associated disease (CDAD) and the role of the hypervirulent strain NAP1 have not been well characterized in Pediatrics.
  
  
  OBJECTIVE
  To describe clinical features of CDAD, and to estimate NAP1 frequency and association with disease severity in Pediatrics.
  
  
  METHODS
  Descriptive, transversal surveillance of diarrheal episodes in Chilean children, hospitalized between February 2012 and December 2013, positive for CD by molecular diagnosis.
  
  
  RESULTS
  A total of 66 episodes of diarrhea with identification of CD occurred thougout the study period in children between 1 month and 19 years of age of which 39% were younger than one year old. CD acquisition was predominantly nosocomial and the most common risk factors were: presence of comorbidities (98.6%), use of antibiotics (93.9%), proton pump inhibitors (84.8%), invasive mechanic ventilation (54.5%), feeding tube (48.5%) and immunosuppression (40.9%). Clinical course was mostly mild, but 12 cases presented an unfavorable course, of which 3/26 occurred in children less than one year. Only one case was positive for NAP1 and had a mild course.
  
  
  CONCLUSIONS
  Diarrhea with identification of CD was present throughout all pediatric ages, including children less than one year old. Analytical and longitudinal studies are required to better characterize the pathogenic role of CD in this age group. CDAD occurred mostly in patients with risk factors, and the clinical course was predominantly mild.
authors.forename: Andrea
authors.initials: A
authors.lastname: Maccioni
authors.forename: Jaime
authors.initials: J
authors.lastname: Cerda
authors.forename: Claudia
authors.initials: C
authors.lastname: Terrazas
authors.forename: Katia
authors.initials: K
authors.lastname: Abarca
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D002677:Chile / Q000453:epidemiology; D016360:Clostridioides difficile / Q000302:isolation & purification*; D003015:Clostridium Infections / Q000453:epidemiology* / Q000382:microbiology; D003428:Cross Infection / Q000453:epidemiology* / Q000382:microbiology; D003430:Cross-Sectional Studies; D003967:Diarrhea / Q000453:epidemiology* / Q000382:microbiology; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D012307:Risk Factors; D012720:Severity of Illness Index; D055815:Young Adult