C difficile 2020

Abstract

The study by Miranda-Katz et al from Kaiser Permanente Northern California approximates the true incidence of community-associated Clostridioides difficile diarrheal disease—13.7 cases per 100 000 per year for the population aged 1 to 17 years. Compared with previous studies, this study has several strengths of broad geographic range, large number of subjects, and optimal testing methods for C difficile and toxin. Equally important, the investigators used rigorous methods to minimize inclusion of colonized but unaffected patients: 1) limiting cases to ages 1 year and older and to those with diarrhea and 2) excluding patients with hospital-acquired infection and those in whom another pathogen also is detected in stool specimen. Using a case-control study format, they also identified the usual risk factors for C difficile as healthcare visits in the preceding year and receipt of certain antimicrobial agents in the preceding three months. This said, the highest case incidence (70 cases/100 000/year) occurred in children in the community between 1 and 2 years of age without remarkable healthcare-related risk factors. This epidemiology has not been widely recognized previously or definitively shown. Here is an alert to the up-to-date consumer of the medical literature. The gurus of medical microbiology have decided that the genus Clostridioides should replace the genus Clostridium for the species difficile. Thankfully, the designation as C difficile or “C diff” still works. Article page 99 ▸ Epidemiology and Risk Factors for Community Associated Clostridioides difficile in ChildrenThe Journal of PediatricsVol. 221PreviewTo assess which risk factors are associated with community-associated Clostridioides difficile infection (CDI) in children. Full-Text PDF