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Risk factors for community-associated Clostridioides difficile infection in young children.
- Source :
-
Epidemiology and infection [Epidemiol Infect] 2019 Jan; Vol. 147, pp. e172. - Publication Year :
- 2019
-
Abstract
- The majority of paediatric Clostridioides difficile infections (CDI) are community-associated (CA), but few data exist regarding associated risk factors. We conducted a case-control study to evaluate CA-CDI risk factors in young children. Participants were enrolled from eight US sites during October 2014-February 2016. Case-patients were defined as children aged 1-5 years with a positive C. difficile specimen collected as an outpatient or ⩽3 days of hospital admission, who had no healthcare facility admission in the prior 12 weeks and no history of CDI. Each case-patient was matched to one control. Caregivers were interviewed regarding relevant exposures. Multivariable conditional logistic regression was performed. Of 68 pairs, 44.1% were female. More case-patients than controls had a comorbidity (33.3% vs. 12.1%; P = 0.01); recent higher-risk outpatient exposures (34.9% vs. 17.7%; P = 0.03); recent antibiotic use (54.4% vs. 19.4%; P < 0.0001); or recent exposure to a household member with diarrhoea (41.3% vs. 21.5%; P = 0.04). In multivariable analysis, antibiotic exposure in the preceding 12 weeks was significantly associated with CA-CDI (adjusted matched odds ratio, 6.25; 95% CI 2.18-17.96). Improved antibiotic prescribing might reduce CA-CDI in this population. Further evaluation of the potential role of outpatient healthcare and household exposures in C. difficile transmission is needed.
- Subjects :
- Case-Control Studies
Child, Preschool
Clostridium Infections microbiology
Community-Acquired Infections epidemiology
Community-Acquired Infections microbiology
Female
Humans
Incidence
Infant
Male
Risk Factors
United States epidemiology
Child Day Care Centers statistics & numerical data
Clostridioides difficile physiology
Clostridium Infections epidemiology
Food Microbiology statistics & numerical data
Outpatients statistics & numerical data
Subjects
Details
- Language :
- English
- ISSN :
- 1469-4409
- Volume :
- 147
- Database :
- MEDLINE
- Journal :
- Epidemiology and infection
- Publication Type :
- Academic Journal
- Accession number :
- 31063097
- Full Text :
- https://doi.org/10.1017/S0950268819000372