Rates of Significant Gastrointestinal Infection On Rise Among Hospitalized Children

CINCINNATI–Researchers at Cincinnati Children’s Hospital Medical Center have documented an increasing national trend of Clostridium difficile infections, a treatable but serious gastrointestinal disease, in hospitalized children.

Their study will be published online Jan.3 in Archives of Pediatrics and Adolescent Medicine.

"There has been a large and significant increase in the national rate of C. difficile infections in hospitalized children, a nearly 15 percent increase each year,” says Mitch Cohen, MD, director of the division of Gastroenterology, Hepatology and Nutrition at Cincinnati Children’s and the study’s senior author.

"This disease is having a significant effect. Children with C. difficile infections have a greater likelihood of death, longer length of hospital stay and higher hospitalization charges than those without the infection.”

Cohen also is a professor of pediatrics and associate professor of internal medicine at the University of Cincinnati College of Medicine.

One of the primary risk factors for the development of C. difficile infection is antibiotic use. While an upward trend in antibiotic use could explain the increase in C. difficile infection, previous studies have shown evidence of a downward trend in antibiotic administration in the United States during this time period, says Cohen.

Other factors, such as the presence of a more virulent strain of C. difficile and increased recognition by health care providers are more likely explanations for the increase in observed cases, he says.

The researchers studied data on nearly 10.5 million children discharged from U.S. hospitals in 1997, 2000, 2003 and 2006. Of these children, 21,274 were diagnosed with C. difficile.

There was an increasing trend of C. difficile, from 3,565 cases in 1997 to 7,779 cases in 2006 – an average increase of 14.9 percent each year In addition to children receiving antibiotics, those with inflammatory bowel disease and those who are immunosuppressed are at higher risk of C. difficile.

Increasing awareness of these risk factors and awareness of the upward trend of C. difficile in hospitalized children is the first step in controlling this important infection, says Cohen.

The lead author of the study was Cade Nylund, MD, who is now with the Uniformed Services University of the Health Sciences in Bethesda, MD. Nylund conducted the study during his gastroenterology fellowship at Cincinnati Children’s.