Risk Factors for Community-Associated Clostridium difficile Infection in Children
| Autor: | Cade M. Nylund, Matthew D. Eberly, Michael Rajnik, Daniel J. Adams |
|---|---|
| Rok vydání: | 2017 |
| Předmět: |
Male
Pediatrics medicine.medical_specialty Adolescent genetic structures Community associated 03 medical and health sciences 0302 clinical medicine Risk Factors 030225 pediatrics Health care Ambulatory Care Humans Medicine 030212 general & internal medicine Sibling Child Outpatient pharmacy Clostridioides difficile business.industry Infant Clindamycin Proton Pump Inhibitors Clostridium difficile Anti-Bacterial Agents Community-Acquired Infections Case-Control Studies Child Preschool Pediatrics Perinatology and Child Health Ambulatory Clostridium Infections Female Diagnosis code business medicine.drug |
| Zdroj: | The Journal of Pediatrics. 186:105-109 |
| ISSN: | 0022-3476 |
| DOI: | 10.1016/j.jpeds.2017.03.032 |
| Popis: | Objective To characterize the medication and other exposures associated with pediatric community-associated Clostridium difficile infections (CA-CDIs). Study design We performed a case-control study using billing records from the US military health system database. CA-CDI cases included children 1-18 years of age with an outpatient International Classification of Diseases, Ninth Revision, Clinical Modification diagnostic code for Clostridium difficile infection (CDI) from 2001 to 2013. Each case was matched to 3 controls without CDI by age and sex. Children hospitalized at any time before their CDI were excluded. Outpatient pharmacy records were used to identify medication exposures in the preceding 12 weeks. In addition, we evaluated recent outpatient healthcare exposure, exposure to a sibling younger than 1 year of age, or to a family member with CDI. Results A total of 1331 children with CA-CDI were identified and 3993 controls were matched successfully. Recent exposure to fluoroquinolones, clindamycin (OR 73.00; 95% CI 13.85-384.68), third-generation cephalosporins (OR 16.32; 95% CI 9.11-29.26), proton pump inhibitors (OR 8.17; 95% CI 2.35-28.38), and to multiple classes of antibiotics, each was associated strongly the subsequent diagnosis of CA-CDI. Recent exposure to outpatient healthcare clinics (OR 1.35; 95% CI 1.31-1.39) or to a family member with CDI also was associated with CA-CDI. Conclusions CA-CDI is associated with medications regularly prescribed in pediatric practice, along with exposure to outpatient healthcare clinics and family members with CDI. Our findings provide additional support for the judicious use of these medications and for efforts to limit spread of CDI in ambulatory healthcare settings and households. |
| Databáze: | OpenAIRE |
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