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Understanding C. difficile Patterns in Children

Clin Infect Dis; ePub 2018 Jan 23; Kociolek, et al

Whole genome sequencing (WGS) identified a highly diverse group of Clostridium difficile (C. difficile) among children with C. difficile infection (CDI), including those with hospital-onset healthcare facility-associated (HCFA) CDI. Researchers performed WGS on C. difficile isolate collected from children diagnosed with CDI between December 2012 and December 2013. Genome sequences of isolates from CDIs diagnosed ≥8 weeks after study initiation were compared to all study isolate genome sequences. Details included:

  • Among 131 CDIs in 107 children, WGS identified 104 genetically distinct isolates.
  • Of 84 incident CDIs occurring ≥8 weeks after study initiation, only 10 (11.9%) were caused by a strain isogenic to another cohort CDI isolate.
  • Proportions of each CDI class putatively associated with transmission were: HCFA, 2/16 (12.5%); community-onset HCFA, 1/17 (5.9%); indeterminate 1/11 (9.1%), community-associated (CA), 5/40 (12.5%), and recurrent, 1/21 (4.8%).
  • Transmission events among CA and HCFA CDIs were similarly infrequent.

Citation:

Kociolek LK, Gerding DN, Espinosa RO, Patel SJ, Shulman ST, Ozer EA. Clostridium difficile whole genome sequencing reveals limited transmission among symptomatic children: A single-center analysis. [Published online ahead of print January 23, 2018]. Clin Infect Dis. doi:10.1093/cid/ciy060.

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