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CDI in children significantly increased in Canadian hospitals
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SAN DIEGO — Rates of Clostridium difficile infections in children have significantly increased in Canadian hospitals, according to study results presented here at ID Week 2012.
Although the burden of illness is well known in older adults, the rates of CDI in children are not well established.
For the study, researchers determined the trends of health care-associated CDI (HA-CDI) in children admitted to hospitals in a national HA infection surveillance system called the Canadian Nosocomial Infection Surveillance Program (CNISP).
CNISP identified laboratory-confirmed HA-CDI in hospitalized patients aged 12 months to 18 years at eight pediatric hospitals from 2007 to 2011.
Nicole Le Saux, MD, physicianin the infectious diseases department of Children’s Hospital of Eastern Ontario Research Institute, and colleagues defined HA-CDI as a disease onset that occurred more than 72 hours after admission from a hospital.
Researchers reported 477 cases of HA-CDI, according to Le Saux.
Enrolled patients had a mean age of 7.6 years. Most of the patients were aged 10 to 18 years.
“The majority of patients come from oncology wards,” Le Saux said. “They are the group that is exposed to antimicrobials.”
A total of 371 patients (77.8%) were discharged at 30 days, and 99 patients (21.7%) remained in the hospital after 30 days.
Seven patients (1.5%) died in the study. CDI was a contributing factor in one patient.
In total, six patients were admitted to the ICU due to complications from HA-CDI (1.2%). At 30 days, doctors discharged four patients from the ICU, one child remained and one child died due to unrelated events.
From 2007-2011, the incidence rates of CDI among children increased 53% (3.2 per 10,000 patient-days in 2007 to 4.9 per 10,000 patient-days in 2011; P<.05), according to results from the study.
“This is a significant increase,” Le Saux said.
Researchers also identified 10 different NAP type strains from the molecular typing of 70 isolates.
The strain types differed from the adult population.
According to Le Saux, NAP 4 (27%), NAP 1 (13%) and non-specified NAP strains (35%) were the most relevant NAP strains in the study.
“A total of 51 patients still do not have NAP designations, which was quite a surprising finding,” Le Saux said.
Researchers are interested in further evaluating the risk factors for pediatric cases of CDI to decrease infection in hospitalized children, Le Saux and colleagues concluded.
For more information:
Le Saux N. Abstract #120. Presented at: ID Week; Oct. 17-21, 2012; San Diego.
Disclosure: Le Saux reported no relevant financial disclosures. Additional researchers reported being an investigator and receiving research grant funds from Afexa, GSK Biologicals, Merck, Novartis, Pfizer and Sanofi-Pasteur,