title: Clostridium Difficile Infection in Children: A Review.
abstract: Clostridium difficile is a sporogenic, anaerobic, Gram-positive, emerging enteric pathogen. It represents the most common cause of health care-associated diarrhoea in the United States, with significantly associated morbidity, mortality, and health care costs. Historically regarded as a little more than an innocent coloniser bystander of the gastrointestinal tract of children, C difficile has increasingly demonstrated its behaviour as a true pathogen in the paediatric age groups. This organism may be responsible for a broad spectrum of diseases in children, ranging from self-limiting secretory diarrhoea to life-threatening conditions, such as pseudomembranous colitis, toxic megacolon, intestinal perforation, and septic shock. The incidence and severity of C difficile infection are, however, not completely understood in this population. In particular, although asymptomatic carriage remains high among infants, the clinical significance of detecting C difficile in children aged 1 to 3 years is not fully understood. Moreover, recent epidemiological surveillance has demonstrated a rise in the incidence of C difficile infection, particularly in the community and in low-risk settings. Interestingly, such cases may not show the disease pattern to be associated with typical risk factors, such as recent exposure to antimicrobial drugs or on-going contacts with the health care system.The purpose of the present review is to present the features of C difficile infection that are unique to paediatric patients and to update paediatricians on information and recommendations regarding C difficile infection in children.
authors.affiliation: Paediatrics Division, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy.
authors.forename: Elena
authors.initials: E
authors.lastname: Borali
authors.forename: Costantino
authors.initials: C
authors.lastname: De Giacomo
mesh_terms: D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D002648:Child; D002675:Child, Preschool; D016360:Clostridioides difficile / Q000302:isolation & purification; D003015:Clostridium Infections / Q000175:diagnosis / Q000453:epidemiology* / Q000628:therapy; D015897:Comorbidity; D003967:Diarrhea / Q000382:microbiology; D006801:Humans; D015994:Incidence; D007223:Infant; D012008:Recurrence; D012307:Risk Factors; D012720:Severity of Illness Index
chemical_list: D000900:Anti-Bacterial Agents