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Aim <p><i>Clostridioides difficile</i> is considered a constituent of the intestinal microbiota, but <i>C. difficile</i>-associated diarrhea (CDAD) is one of the main causes of healthcare-associated infections (HAIs).</p> Objectives <p>This study aimed to assess the prevalence of <i>Clostridioides difficile</i> infection, identify associated clinical variables, and describe specific treatment strategies in a Brazilian pediatric hospital.</p> Methods <p>Study design, this is a case–control study conducted by active surveillance of patients aged between 0 and 18&#xa0;years admitted and treated as a suspected case of <i>C. difficile</i> infection (CDI). Participant selection, we included 251 children and adolescents with clinical suspicion of CDI, of which 62 (24.7%) had toxins A and/or B or glutamate dehydrogenase (GDH) detected in fecal samples. Statistical techniques, the variables were categorized and quantified by frequency percentage, and the chi-square statistical test (X<sup>2</sup>) was used to compare the proportions, with <i>p</i> &lt; 0.05 as the threshold of statistical significance.</p> Results <p>The variables associated with infection were hypoalbuminemia (<i>p</i> = 0.047), previous inflammatory disease (<i>p</i> = 0.005), altered radiological image (<i>p</i> = 0.026), and hemodynamic instability (<i>p</i> = 0.003) during colitis. The clinical outcomes were death (<i>p</i> = 0.034), recurrence (<i>p</i> &lt; 0.001), and persistence of diarrhea (<i>p</i> = 0.001) and toxins A and/or B (<i>p</i> = 0.007) in fecal samples.</p> Conclusions <p>In conclusion, although the incidence of CDI and the associated mortality in Minas Gerais are relatively low in the national context, they remain higher than the rates reported in the United States and Europe, our findings reinforced the importance of active surveillance of this infection, particularly in patients with risk factors, and implementation of stricter preventive measures to contain CDI in a hospital environment.</p>

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A case–control study in children and adolescents with clostridioides difficile infection in a hospital in Brazil

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年5月4日

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  • Paula Aparecida de Assis Soares,
  • Santiago Martín Lattar,
  • Daniela Caldas Teixeira,
  • Daiana Elias Rodrigues,
  • Raquel Amaral Machado,
  • Luciano Amédée Péret Filho,
  • Aline Almeida Bentes

摘要

Aim

Clostridioides difficile is considered a constituent of the intestinal microbiota, but C. difficile-associated diarrhea (CDAD) is one of the main causes of healthcare-associated infections (HAIs).

Objectives

This study aimed to assess the prevalence of Clostridioides difficile infection, identify associated clinical variables, and describe specific treatment strategies in a Brazilian pediatric hospital.

Methods

Study design, this is a case–control study conducted by active surveillance of patients aged between 0 and 18 years admitted and treated as a suspected case of C. difficile infection (CDI). Participant selection, we included 251 children and adolescents with clinical suspicion of CDI, of which 62 (24.7%) had toxins A and/or B or glutamate dehydrogenase (GDH) detected in fecal samples. Statistical techniques, the variables were categorized and quantified by frequency percentage, and the chi-square statistical test (X2) was used to compare the proportions, with p < 0.05 as the threshold of statistical significance.

Results

The variables associated with infection were hypoalbuminemia (p = 0.047), previous inflammatory disease (p = 0.005), altered radiological image (p = 0.026), and hemodynamic instability (p = 0.003) during colitis. The clinical outcomes were death (p = 0.034), recurrence (p < 0.001), and persistence of diarrhea (p = 0.001) and toxins A and/or B (p = 0.007) in fecal samples.

Conclusions

In conclusion, although the incidence of CDI and the associated mortality in Minas Gerais are relatively low in the national context, they remain higher than the rates reported in the United States and Europe, our findings reinforced the importance of active surveillance of this infection, particularly in patients with risk factors, and implementation of stricter preventive measures to contain CDI in a hospital environment.