An increasing number of hospitalized children are becoming infected with a type of bacteria known as Clostridium difficile, which can cause severe diarrhea and even death, according to a new study.
The results show the number of cases of Clostridium difficile infection, or CDI, among hospitalized children rose by about 15 percent each year between 1997 and 2006.
“If children get this, they're more likely to die, they're more likely to have surgery, they're going to be in the hospital longer, so there's a significant impact of the disease,” said study researcher Dr. Cade Nylund, of the Uniformed Services University of the Health Sciences in Bethesda, Md.
Overall, children with CDI were 1.2 times more likely to die while hospitalized than those with other conditions, the study showed. They were also 4.3 times more likely to have a longer hospital stay, and about 1.4 times more likely to require surgery to remove all or part of their colons, a procedure known as a colectomy.
The rise in cases may be due to the emergence of a more virulent strain of the bacteria, Nylund said. This strain is more noxious than previous strains, and more resistant to medications.
An increase in antibiotic prescriptions for children may also explain the trend, the researchers said. Taking antibiotics is known to increase the risk of CDI — antibiotics wipe out the “good” bacteria in the gut, which makes it easier for “bad” bacteria to settle in.
Knowing who is at risk for the disease, as well as identifying it early enough to prevent its spread among hospital patients, could help stem the rising trend of infections, Nylund said.
Nylund and his colleagues examined a national database that included information on children discharged from hospitals in 1997, 2000, 2003 and 2006. Out of about 10.5 million children, 21,274, or 0.2 percent, were identified as having CDI.
The number of CDI cases increased from 3,565 in 1997 to 7,779 in 2006. The uptick in cases held even after the researchers accounted for differences in the total number of patients hospitalized between those years, Nylund said.
Children who were white, had private insurance and lived in urban areas were more likely to be infected with Clostridium difficile than those who were black or Hispanic, had Medicaid and lived in rural areas, the researchers said.
The disease may be more common among the privately insured because these children may be more likely to be put on antibiotics, and thus more susceptible to CDI, Nylund said.
Certain conditions, including inflammatory bowel disease, also put children at an increased risk for CDI.
CDI has been considered a disease that occurs primarily in hospitals, but there are reports of the condition becoming more common in the general population, Nylund said. The researchers noted that from their data, they could not distinguish between patients who acquired the disease in the hospital and those who were already infected when they were hospitalized.
Within hospitals, better isolation of patients with CDI may be one way to prevent the disease's spread.
“If it's acquired in the hospital, then it can be very easily transmitted from one patient to the next,” Nylund said. “So it's important to have good isolation and preventive measures within the hospital to prevent transfer from one sick child to the next.”
The results are published online today in the Archives of Pediatrics & Adolescent Medicine.The study was funded by the Agency for Healthcare Research and Quality, part of the U.S. Department of Health and Human Services.
Pass it on: More hospitalized children are becoming infected with Clostridium difficile. The disease may increase the risk of death for children by 20 percent.
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