Risk Factors for Recurrent Clostridium difficile Infection in Children: A Nested Case-Control Study Journal Article

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Authors: Kociolek, L. K.; Palac, H. L.; Patel, S. J.; Shulman, S. T.; Gerding, D. N.
Article Title: Risk Factors for Recurrent Clostridium difficile Infection in Children: A Nested Case-Control Study
Abstract: OBJECTIVE: To identify risk factors for recurrent Clostridium difficile infection (RCDI) in children. STUDY DESIGN: A nested case-control study was performed to identify RCDI risk factors using a pediatric cohort of inpatients and outpatients diagnosed with Clostridium difficile infection by tcdB polymerase chain reaction (PCR) at an academic children's hospital between December 9, 2012, and June 30, 2014. Strict inclusion criteria were adopted to limit selection bias related to inappropriate inclusion of patients with probable C difficile colonization. RESULTS: Thirty children with RCDI were compared with 94 children with non-RCDI. Statistically significant associations were identified between RCDI and malignancy (OR 2.8, 95% CI 1.0-7.4, P = .044), tracheostomy tube dependence (OR 5.2, 95% CI 1.1-24.7, P = .037), and tcdB PCR cycle threshold (OR 0.87, 95% CI 0.78-0.97, P = .01) using multivariable logistic regression modeling. The receiver operator characteristic curve for PCR cycle threshold as a predictor of RCDI demonstrated area under the curve = 0.67. The highest predictive rate (75%) for RCDI was demonstrated at cycle threshold cutpoint
Journal Title: The Journal of pediatrics
Volume: 167
Issue: 2
ISSN: 1097-6833; 0022-3476
Publisher: Unknown  
Date Published: 2015
Start Page: 384
End Page: 389