Abstract
OBJECTIVES: To compare the incidence, epidemiology, testing patterns, treatment, and outcomes of Clostridioides difficile infection (CDI) among hospitalized pediatric patients from 2013 to 2019. STUDY DESIGN: The Pediatric Health Information System database was queried for patient admissions (age 0-17 years) with International Classification of Diseases, 9th and 10th edition, codes for diagnoses of CDI with a billing code for a CDI-related antibiotic treatment. RESULTS: We identified 17 142 pediatric patients, representing 23 052 admissions, with CDI. The adjusted annual CDI incidence decreased over the study period from 7.09 cases per 10 000 patient-days (95% CI, 6.15-8.18) in 2013 to 4.89 cases per 10 000 patient-days (95% CI, 4.03-5.93) in 2019 (P < .001). c difficile-specific testing also decreased during the study period (p >< .001). chronic gastrointestinal conditions (36%) and malignancy (32%) were the most common comorbidities in cdi encounters. oral metronidazole use decreased during the study period (p >< .01) and oral vancomycin use increased (p >< .001). conclusions: our study demonstrates a decrease in cdi incidence in hospitalized pediatric patients, a notable change from prior studies, although this may have been influenced by altered testing patterns. we found a high incidence of cdi in patients with cancer and gastrointestinal conditions: groups that warrant targeted evaluation of cdi prevention and treatment.>
