Risk factors and outcomes associated with severe clostridium difficile infection in children.

Background: The incidence and severity of Clostridium difficile infection (CDI) is increasing among adults; however, little is known about the epidemiology of CDI among children.

Methods: We conducted a nested case-control study to identify the risk factors for and a prospective cohort study to determine the outcomes associated with severe CDI at 2 children's hospitals. Severe CDI was defined as CDI and at least 1 complication or ≥2 laboratory or clinical indicators consistent with severe disease.

Low frequency of endemic patient-to-patient transmission of antibiotic-resistant gram-negative bacilli in a pediatric intensive care unit.

We sought to determine the frequency of horizontal transmission of antibiotic-resistant gram-negative bacilli (ARGNB) in a pediatric intensive care unit during a nonoutbreak period. Among 5,300 admissions over 39 consecutive months, 13 ARGNB clusters involving 35 children were identified by pulsed-filed gel electrophoresis analysis, which suggests that person-to-person transmission was uncommon.

Presence of the epidemic North American Pulsed Field type 1 Clostridium difficile strain in hospitalized children.

A hypervirulent strain of Clostridium difficile-labeled North American Pulsed Field type 1 causes severe disease in adults. To determine the prevalence of NAP1 C. difficile in children, organisms from consecutive C.