Abstract
OBJECTIVE: To analyze clinical characteristics and risk factors for recurrence of Clostridioides difficile infection (CDI) in children. METHODS: Clinical data were retrospectively collected from all children (<18 years) hospitalized with CDI at Tianjin Children's Hospital between September 2018 and December 2023. RESULTS: In total, 115 patients (66 males and 49 females;) were divided into recurrence (n = 38) and non-recurrence (n = 77) groups. Logistic regression was used to compare clinical data and analyze risk factors for CDI recurrence. The recurrent CDI(rCDI) and non-recurrence groups had statistically significant differences in terms of age, comorbidities, prior antibiotic exposure, mode of CDI acquisition (hospital vs. community), colonoscopy(the rationale for colonoscopy data inclusion-diagnosis confirmation or ruling out other causes), treatment selection, levels of interleukin-6 and creatine kinase, and body mass index (p < 0.05). Multivariate analysis showed that healthcare-associated CDI [odds ratio [OR] = 14.754, 95% confidence interval [CI]:4.568-47.650, p = 0.000] is an independent risk factor for CDI recurrence in children (p < 0.05), with sensitivity and specificity of 73.7% and 87.0%, respectively. CONCLUSION: Healthcare-associated CDI (HA-CDI)is an independent risk factor for pediatric rCDI, and the introduction of this indicator in diagnosis has certain accuracy in predicting rCDI.