ArticleJournal of the Pediatric Infectious Diseases Society2014
Variation in Risk of Hospital-Onset Clostridium difficile Infection Across β-Lactam Antibiotics in Children With New-Onset Acute Lymphoblastic Leukemia.
Article in Journal of the Pediatric Infectious Diseases Society, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 12 papers, 1 of them a synthesis that pooled it.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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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
12 citing papers in PubMed, 1 synthesis or guideline pooled it, 21 citations in OpenAlex.
- Trends in Clostridioides difficile infection prevalence among pediatric cancer patients: A systematic review and meta-analysis.PloS one · 2025Pooled it
- Which Type of Empiric Antibiotic Therapy is Appropriate? A 20-Year Retrospective Study of Bloodstream Infections in Childhood Cancer.Infectious diseases and therapy · 2021Article
- Recurrent community-acquired Clostridium(Clostridioides)difficile infection in Serbianchildren.European journal of clinical microbiology & infectious diseases : official publication of the European Society of Clinical Microbiology · 2020Article
- Clostridioides difficile-Associated Diarrhea: Infection Prevention Unknowns and Evolving Risk Reduction Strategies.Current infectious disease reports · 2019Review
- Hospital-Level Variability in Broad-Spectrum Antibiotic Use for Children With Acute Leukemia Undergoing Hematopoietic Cell Transplantation.Infection control and hospital epidemiology · 2018Article
- Investigation of Clostridium difficile ribotypes in symptomatic patients of a German pediatric oncology center.European journal of pediatrics · 2018Article
- Adverse Effects of Intravenous Vancomycin-Based Prophylaxis during Therapy for Pediatric Acute Myeloid Leukemia.Antimicrobial agents and chemotherapy · 2018Article
- TargetingFrontiers in microbiology · 2018Review
- Levofloxacin Prophylaxis During Induction Therapy for Pediatric Acute Lymphoblastic Leukemia.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2017Observational
- [Pathogens of infections in the induction period of childhood acute lymphoblastic leukemia and drug resistance of isolated strains].Zhongguo dang dai er ke za zhi = Chinese journal of contemporary pediatrics · 2017Article
- Gastrointestinal and liver infections in children undergoing antineoplastic chemotherapy in the years 2000.World journal of gastroenterology · 2016Review
- Use of Concomitant Antibiotics During Treatment for Clostridium difficile Infection (CDI) in Pediatric Inpatients: An Observational Cohort Study.Infectious diseases and therapy · 2016Article
Corrections and comments
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Authors and funding
13 authors at 5 institutions in 1 country.
Funding
Abstract
backgroundAntibiotic exposure is common among children with leukemia. However, limited data exist regarding the risk of Clostridium difficile infection (CDI) across anti-pseudomonal β-lactam antibiotics commonly used for fever and neutropenia.
methodsA multicenter cohort of children with newly diagnosed acute lymphoblastic leukemia (ALL) was established from 43 freestanding children's hospitals from 1999 to 2009. Patients were followed until their index CDI event, defined by the CDI ICD-9 code plus a C difficile test charge, or until 180 days from ALL diagnosis. Cox proportional hazards models were performed to identify the hazards of CDI after exposure to anti-pseudomonal β-lactams, adjusting for demographics, other antibiotic exposures, severity of illness, antacids, gastrointestinal manipulation, and confounding by hospital.
resultsA cohort of 8268 ALL patients was assembled; median age was 5.5 years (interquartile range, 3.26-10.58). Two-hundred sixty-eight (3.2%) patients developed CDI within 180 days of ALL diagnosis. Each 1-day increase in exposure to an anti-pseudomonal β-lactam within the prior 30 days was associated with a significantly increased risk for CDI (hazard ratio [HR], 1.05; 95% confidence interval [CI], 1.01, 1.09). Ceftazidime (HR, 1.05; 95% CI, 1.02, 1.08) and cefepime (HR, 1.07; 95% CI, 1.02, 1.12) were each independently associated with CDI.
conclusionsEfforts to reduce total exposure to anti-pseudomonal β-lactam agents may help to reduce the risk of CDI in children with newly diagnosed ALL. Cefepime and ceftazidime were independently associated with CDI, whereas anti-pseudomonal penicillins and carbapenems were not. These findings, if confirmed, have potential implications for antibiotic choice during periods of fever and neutropenia.
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