ArticlePloS one2012
Five years experience of Clostridium difficile infection in children at a UK tertiary hospital: proposed criteria for diagnosis and management.
Article in PloS one, 2012. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 21 papers, 3 of them syntheses that pooled it.
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The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
21 citing papers in PubMed, 3 syntheses or guidelines pooled it, 49 citations in OpenAlex.
- Comparison of pediatric and adult antibiotic-associated diarrhea and Clostridium difficile infections.World journal of gastroenterology · 2016Pooled it
- Co-infection as a confounder for the role of Clostridium difficile infection in children with diarrhoea: a summary of the literature.European journal of clinical microbiology & infectious diseases : official publication of the European Society of Clinical Microbiology · 2015Pooled it
- The impact of Clostridium difficile on paediatric surgical practice: a systematic review.Pediatric surgery international · 2014Pooled it
- Review
- Vitamin D supplementation in pregnancy and early infancy in relation to gut microbiota composition andGut microbes · 2020Article
- Molecular characteristics of Clostridium difficile in children with acute gastroenteritis from Zhejiang.BMC infectious diseases · 2020Article
- Transmission ofInfection control and hospital epidemiology · 2020Article
- HighInternational journal of pediatrics · 2020Article
- Clinical Efficacy and Microbiome Changes Following Fecal Microbiota Transplantation in Children With Recurrent Clostridium Difficile Infection.Frontiers in microbiology · 2018Article
- Clostridium difficile infection in children: epidemiology and risk of recurrence in a low-prevalence country.European journal of clinical microbiology & infectious diseases : official publication of the European Society of Clinical Microbiology · 2017Observational
- Treatment of pediatricInfection and drug resistance · 2017Review
- Article
- Clostridium difficile Infection in Special High-Risk Populations.Infectious diseases and therapy · 2016Review
- The role of Clostridium difficile in the paediatric and neonatal gut - a narrative review.European journal of clinical microbiology & infectious diseases : official publication of the European Society of Clinical Microbiology · 2016Review
- Clostridium difficile Infection.Microbiology spectrum · 2016Review
- Controversies Surrounding Clostridium difficile Infection in Infants and Young Children.Children (Basel, Switzerland) · 2014Review
- Clostridium difficile in Children: To Treat or Not to Treat?Pediatric gastroenterology, hepatology & nutrition · 2014Review
- Clostridium difficile infection in children hospitalized due to diarrhea.European journal of clinical microbiology & infectious diseases : official publication of the European Society of Clinical Microbiology · 2014Article
- Severe clinical outcome is uncommon in Clostridium difficile infection in children: a retrospective cohort study.BMC pediatrics · 2014Article
- Intestinal inflammatory biomarkers and outcome in pediatric Clostridium difficile infections.The Journal of pediatrics · 2013Article
Corrections and comments
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Authors and funding
4 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundClostridium difficile infection (CDI) is associated with significant morbidity and mortality in adults. There is increasing evidence of the pathogenic role of C. difficile in the paediatric population. We sought to ascertain the clinical presentation and severity of CDI in children at our institution and develop criteria to aid management.
methodsClinical data was retrospectively collected from all children (0-16 yrs) with a positive C. difficile toxin result over a 5-year period. National adult guidelines were used to assess the severity and management of CDI.
resultsSeventy-five patients were included with a mean age of 2.97 years. Forty-nine were hospital onset, 22 community onset and 4 healthcare-associated. The most common co-morbidity among the hospital onset infections was malignancy. Gastrointestinal conditions were most common among community onset infections. Fifty-five cases (73.3%) had received antibiotics in the preceding month, 7 (9.3%) had cow's milk intolerance and 9 (12%) had co-infection with another gut pathogen. According to national adult guidelines 57 cases (76%) were categorised as severe. Thirty cases received oral metronidazole, two patients required intensive care and one patient had a sub-total colectomy for pseudomembranous colitis. No mortality was observed. DISCUSSION: We confirm the association of paediatric CDI with co-morbidities such as haematological and solid organ malignancies, recent antibiotic use and hospitalisation. We observed an association between cows milk protein intolerance and C. difficile. The use of adult criteria overestimated severity of disease in this cohort, as most cases experienced a mild course of illness with low morbidity and no mortality. This indicates that adult scoring criteria are not useful in guiding management and we propose specific criteria for children.
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