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Distribution and risk factor analysis for Clostridium difficile‐associated diarrhea among hospitalized children over one year of age

IMPORTANCE: Clostridium difficile‐associated diarrhea (CDAD) is a severe type of antibiotic‐associated diarrhea (AAD). However, the risk factors for CDAD in children with AAD have not yet been clarified. OBJECTIVE: To investigate the distribution and risk factors for CDAD among hospitalized children...

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Autores principales: Zhao, Chunna, Guo, Shu, Jia, Xiaoyun, Xu, Xiwei
Formato: Online Artículo Texto
Lenguaje:English
Publicado: John Wiley and Sons Inc. 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7331383/
https://www.ncbi.nlm.nih.gov/pubmed/32851340
http://dx.doi.org/10.1002/ped4.12155
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author Zhao, Chunna
Guo, Shu
Jia, Xiaoyun
Xu, Xiwei
author_facet Zhao, Chunna
Guo, Shu
Jia, Xiaoyun
Xu, Xiwei
author_sort Zhao, Chunna
collection PubMed
description IMPORTANCE: Clostridium difficile‐associated diarrhea (CDAD) is a severe type of antibiotic‐associated diarrhea (AAD). However, the risk factors for CDAD in children with AAD have not yet been clarified. OBJECTIVE: To investigate the distribution and risk factors for CDAD among hospitalized children in Beijing Children’s Hospital. METHODS: Stool samples from 197 children with AAD were tested for the C. difficile pathogenic genes (tcdA, tcdB, tcdC, tcdD, tcdE, cdtA, and cdtB) using polymerase chain reaction between January 2011 and January 2014. Children who tested positive for tcdA or tcdB were included in the CDAD group, and those remaining comprised the non‐CDAD group. RESULTS: The rate of CDAD among the 197 children with AAD was 42.6% (84/197). The age distribution was 1–15.6 years, among which the majority of children (54.8%, 46/84) were aged 1–4 years. Differences in the CDAD‐positive rates among AAD children belonging to different age groups were not statistically significant. Univariate analysis revealed that the duration of antibiotic therapy, the length of hospitalization prior to diarrhea, and gastrointestinal tract operations were significant risk factors (P < 0.05). Children with CDAD underwent more antibiotic therapy and had longer periods of hospitalization prior to diarrhea onset than children in the non‐CDAD group. Using multivariate regression analysis, hospitalization for ≥ 10 days prior to diarrhea was found to be an independent risk factor for CDAD. INTERPRETATION: This study revealed that the length of hospitalization (≥ 10 days) prior to diarrhea was an independent risk factor for CDAD in children with AAD.
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spelling pubmed-73313832020-08-25 Distribution and risk factor analysis for Clostridium difficile‐associated diarrhea among hospitalized children over one year of age Zhao, Chunna Guo, Shu Jia, Xiaoyun Xu, Xiwei Pediatr Investig Original Article IMPORTANCE: Clostridium difficile‐associated diarrhea (CDAD) is a severe type of antibiotic‐associated diarrhea (AAD). However, the risk factors for CDAD in children with AAD have not yet been clarified. OBJECTIVE: To investigate the distribution and risk factors for CDAD among hospitalized children in Beijing Children’s Hospital. METHODS: Stool samples from 197 children with AAD were tested for the C. difficile pathogenic genes (tcdA, tcdB, tcdC, tcdD, tcdE, cdtA, and cdtB) using polymerase chain reaction between January 2011 and January 2014. Children who tested positive for tcdA or tcdB were included in the CDAD group, and those remaining comprised the non‐CDAD group. RESULTS: The rate of CDAD among the 197 children with AAD was 42.6% (84/197). The age distribution was 1–15.6 years, among which the majority of children (54.8%, 46/84) were aged 1–4 years. Differences in the CDAD‐positive rates among AAD children belonging to different age groups were not statistically significant. Univariate analysis revealed that the duration of antibiotic therapy, the length of hospitalization prior to diarrhea, and gastrointestinal tract operations were significant risk factors (P < 0.05). Children with CDAD underwent more antibiotic therapy and had longer periods of hospitalization prior to diarrhea onset than children in the non‐CDAD group. Using multivariate regression analysis, hospitalization for ≥ 10 days prior to diarrhea was found to be an independent risk factor for CDAD. INTERPRETATION: This study revealed that the length of hospitalization (≥ 10 days) prior to diarrhea was an independent risk factor for CDAD in children with AAD. John Wiley and Sons Inc. 2019-10-28 /pmc/articles/PMC7331383/ /pubmed/32851340 http://dx.doi.org/10.1002/ped4.12155 Text en © 2019 Chinese Medical Association. Pediatric Investigation published by John Wiley & Sons Australia, Ltd on behalf of Futang Research Center of Pediatric Development This is an open access article under the terms of the http://creativecommons.org/licenses/by-nc-nd/4.0/ License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non‐commercial and no modifications or adaptations are made.
spellingShingle Original Article
Zhao, Chunna
Guo, Shu
Jia, Xiaoyun
Xu, Xiwei
Distribution and risk factor analysis for Clostridium difficile‐associated diarrhea among hospitalized children over one year of age
title Distribution and risk factor analysis for Clostridium difficile‐associated diarrhea among hospitalized children over one year of age
title_full Distribution and risk factor analysis for Clostridium difficile‐associated diarrhea among hospitalized children over one year of age
title_fullStr Distribution and risk factor analysis for Clostridium difficile‐associated diarrhea among hospitalized children over one year of age
title_full_unstemmed Distribution and risk factor analysis for Clostridium difficile‐associated diarrhea among hospitalized children over one year of age
title_short Distribution and risk factor analysis for Clostridium difficile‐associated diarrhea among hospitalized children over one year of age
title_sort distribution and risk factor analysis for clostridium difficile‐associated diarrhea among hospitalized children over one year of age
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7331383/
https://www.ncbi.nlm.nih.gov/pubmed/32851340
http://dx.doi.org/10.1002/ped4.12155
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