Huang Jin-Yue, Wang Ning, Wang Jing-Yao, Zuo Hua-Chu, Li Juan, Zhao Yu
Tianjin Pediatric Research Institute, Tianjin Key Laboratory of Birth Defects for Prevention and Treatment, Tianjin Children's Hospital (Children's Hospital of Tianjin University), Tianjin, China.
Department of Gastroenterology, Tianjin Children's Hospital (Children's Hospital of Tianjin University), Tianjin, China.
Front Pediatr. 2025 Jul 18;13:1571199. doi: 10.3389/fped.2025.1571199. eCollection 2025.
To analyze clinical characteristics and risk factors for recurrence of infection (CDI) in children.
Clinical data were retrospectively collected from all children (<18 years) hospitalized with CDI at Tianjin Children's Hospital between September 2018 and December 2023.
In total, 115 patients (66 males and 49 females;) were divided into recurrence ( = 38) and non-recurrence ( = 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 ( < 0.05). Multivariate analysis showed that healthcare-associated CDI [odds ratio [OR] = 14.754, 95% confidence interval []:4.568-47.650, = 0.000] is an independent risk factor for CDI recurrence in children ( < 0.05), with sensitivity and specificity of 73.7% and 87.0%, respectively.
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.
分析儿童艰难梭菌感染（CDI）的临床特征及复发的危险因素。
回顾性收集2018年9月至2023年12月期间在天津市儿童医院住院的所有CDI患儿（<18岁）的临床资料。
共115例患者（男66例，女49例）分为复发组（n = 38）和非复发组（n = 77）。采用Logistic回归比较临床资料并分析CDI复发的危险因素。复发性CDI（rCDI）组和非复发组在年龄、合并症、既往抗生素暴露史、CDI获得方式（医院获得性与社区获得性）、结肠镜检查（纳入结肠镜检查数据的理由——确诊或排除其他病因）、治疗选择、白细胞介素-6和肌酸激酶水平以及体重指数方面存在统计学显著差异（P < 0.05）。多因素分析显示，医疗保健相关CDI[比值比（OR）= 14.754，95%置信区间（CI）：4.568 - 47.650，P = 0.000]是儿童CDI复发的独立危险因素（P < 0.05），其敏感度和特异度分别为73.7%和87.0%。
医疗保健相关CDI（HA-CDI）是儿童rCDI的独立危险因素，将该指标纳入诊断对预测rCDI具有一定准确性。
