Clostridium difficileInfections in Children

During the past decade, rates of Clostridium difficile infection (CDI) increased worldwide.Hypervirulent strains of C. difficile such as NAP1/BI/027 and PCR ribotype 078 have emerged that have changed the epidemiology of CDI.Especially, CDI rates also have increased in the community, in children previously thought to be at low risk.Recently, the use of gastric acid suppressant that facilitates intestinal transit of the bacteria and presence of inflammatory bowel disease has been reported as risk factors.Treatment for CDI usually relies on metronidazole or vancomycin, but recurrence rates remains high.New treatment options for multiple recurrence are challenging.In this article, we reviewed recent epidemiological changes, current knowledge of virulence factors, reasonable approach to the diagnosis, and optimal treatment of CDI.But, clinical guidelines for pediatric C. difficile disease have not been defined.It seems that the consensus and recommendations for managing pediatric CDI are urgently needed.(Ewha Med J 2011;34(2):3-12)