Clostridium Infection on the Rise in Hospitalized Kids

Jan. 4, 2011 -- The number of hospitalized children infected by a potentially dangerous bacterium is on the rise, according to a new study.

The infection occurs from bacteria known as Clostridium difficile, which affects the gastrointestinal tract and can be deadly. These infections among hospitalized children rose nearly 15% a year during the time period studied, 1997 to 2006.

''If a child gets Clostridium difficile, they are more likely to die than those without the diagnosis, and they are more likely to require surgery of the colon and have a more complex hospital stay," says researcher Cade M. Nylund, MD, an assistant professor of pediatrics at the Uniformed Services University of the Health Sciences in Bethesda, Md.

The study is published online in the Archives of Pediatrics & Adolescent Medicine.

C.diff is common in hospitals and is also found in the community.

Clostridium Infection: Study Details

Nylund and his colleagues evaluated the records of hospitalized children from a national database of patients who were discharged from hospitals in the years 1997, 2000, 2003, and 2006.

The database included about 10.5 million children, and 0.2%, or 21,274, were infected.

Nylund decided to take a look while he was at the Cincinnati Children's Hospital Medical Center in Cincinnati because of the large number of infections he saw there. His daughter was infected at age 6, but recovered.

Nylund and his co-researchers found that children with the infection:

• Had a 20% increased risk of dying compared to children without the diagnosis
• Were 36% more likely to need colon surgery
• Were more than four times as likely to have a longer hospital stay.

Children who have inflammatory bowel disease and children with a suppressed immune system (from chemotherapy or HIV, for instance) are at higher risk of becoming infected, he says.

Explaining Rising Cases of Clostridium Difficile

Exactly why the infection is increasing among hospitalized children is not known, the researchers say.

"Increasing awareness is part of it," says researcher Mitchell B. Cohen, MD, director of the division of gastroenterology, hepatology, and nutrition at Cincinnati Children's Hospital Medical Center.

"Antibiotic exposure used to be thought to be required," he says. "Now, it's considered a risk factor," with not all who become infected taking antibiotics.

In fact, antibiotic use went down during the study period, other research shows.

The database did not include information on whether the children were on antibiotics, Nylund says, so he can't say how much that may have boosted risk.

Another possibility is that a more virulent strain of the bacterium is circulating.