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Baldassarre L, Quach-Thanh C, Mouajou Feujio V, Tadount F, Deyirmendjian C, Lefebvre MA, Thampi N, Schneider O, Fabri-Karam I, O'Donnell S, Okeny-Owere J, Audy N, Desmarais N. Incidence and risk factors for recurrent Clostridioides difficile infection in pediatric at-risk groups in selected Pediatric Investigators Collaborative Network on Infections in Canada (PICNIC) hospitals. Infect Control Hosp Epidemiol 2024; 45:182-187. [PMID: 37700539 DOI: 10.1017/ice.2023.174] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/14/2023]
Abstract
OBJECTIVES Incidence and risk factors for recurrent Clostridioides difficile infection (rCDI) are well established in adults, though data are lacking in pediatrics. We aimed to determine incidence of and risk factors for rCDI in pediatrics. METHODS This retrospective cohort study of pediatric patients was conducted at 3 tertiary-care hospitals in Canada with laboratory-confirmed CDI between April 1, 2012, and March 31, 2017. rCDI was defined as an episode of CDI occurring 8 weeks or less from diagnostic test date of the primary episode. We used logistic regression to determine and quantify risk factors significantly associated with rCDI. RESULTS In total, 286 patients were included in this study. The incidence proportion for rCDI was 12.9%. Among hospitalized patients, the incidence rate was estimated at 2.6 cases of rCDI per 1,000 hospital days at risk (95% confidence interval [CI], 1.7-3.9). Immunocompromised patients had higher incidence of rCDI (17.5%; P = .03) and higher odds of developing rCDI independently of antibiotic treatment given for the primary episode (odds ratio [OR], 2.31; 95% CI, 1.12-5.09). Treatment with vancomycin monotherapy did not show statistically significant protection from rCDI, independently of immunocompromised status (OR, 0.33; 95% CI, 0.05-1.15]). CONCLUSIONS The identification of increased risk of rCDI in immunocompromised pediatric patients warrants further research into alternative therapies, prophylaxis, and prevention strategies to prevent recurrent disease burden within these groups. Treatment of the initial episode with vancomycin did not show statistically significant protection from rCDI.
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Affiliation(s)
- Lucila Baldassarre
- Department of Microbiology, Infectious Disease, and Immunology, University of Montreal, Montreal, Québec, Canada
| | - Caroline Quach-Thanh
- Department of Microbiology, Infectious Disease, and Immunology, University of Montreal, Montreal, Québec, Canada
- Centre Hospitalier Universitaire Sainte Justine Research Centre, Montreal, Québec, Canada
| | - Verinsa Mouajou Feujio
- Department of Microbiology, Infectious Disease, and Immunology, University of Montreal, Montreal, Québec, Canada
| | - Fazia Tadount
- Centre Hospitalier Universitaire Sainte Justine Research Centre, Montreal, Québec, Canada
| | - Claudia Deyirmendjian
- Department of Microbiology, Infectious Disease, and Immunology, University of Montreal, Montreal, Québec, Canada
| | - Marie-Astrid Lefebvre
- Division of Infectious Diseases, Department of Paediatrics, The Montreal Children's Hospital of the McGill University Health Centre, Montreal, Québec, Canada
| | - Nisha Thampi
- Children's Hospital of Eastern Ontario, Division of Infectious Diseases, Immunology and Allergy, Department of Pediatrics, Ottawa, Ontario, Canada
| | - Oliver Schneider
- Department of Family Medicine and Emergency Medicine, University of Montreal, Montreal, Québec, Canada
| | - Isabela Fabri-Karam
- Research Institute of the McGill University Health Centre, Montreal, Québec, Canada
| | - Shauna O'Donnell
- Infection Prevention & Control, Centre Hospitalier Universitaire Sainte Justine, Montreal, Québec, Canada
| | - James Okeny-Owere
- Children's Hospital of Eastern Ontario, Division of Infectious Diseases, Immunology and Allergy, Department of Pediatrics, Ottawa, Ontario, Canada
| | - N Audy
- Infection Prevention & Control, Centre Hospitalier Universitaire Sainte Justine, Montreal, Québec, Canada
| | - Nadia Desmarais
- Infection Prevention & Control, Centre Hospitalier Universitaire Sainte Justine, Montreal, Québec, Canada
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Zahradnik S, Tsampalieros A, Okeny-Owere J, Webster RJ, Bedard P, Seidman G, Thampi N. Hand hygiene knowledge and practices of family caregivers in inpatient pediatrics. Infect Control Hosp Epidemiol 2024; 45:253-256. [PMID: 37728055 DOI: 10.1017/ice.2023.204] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/21/2023]
Abstract
Family caregivers are essential inpatient pediatric care partners, yet their handwashing knowledge and compliance are rarely studied. Through hand hygiene audits and self-administered questionnaires, we observed 9% compliance, significantly lower than self-reported practice. We suggest interventions to improve caregiver handwashing behaviors to decrease infection transmission risk to hospitalized children.
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Affiliation(s)
- Stephanie Zahradnik
- Department of Pediatrics, University of Ottawa Faculty of Medicine, Ottawa, Ontario, Canada
| | - Anne Tsampalieros
- Children's Hospital of Eastern Ontario, Clinical Research Unit, Ottawa, Ontario, Canada
| | - James Okeny-Owere
- Department of Chemistry and Biomolecular Sciences, University of Ottawa, Ottawa, Ontario, Canada
| | - Richard J Webster
- Children's Hospital of Eastern Ontario, Clinical Research Unit, Ottawa, Ontario, Canada
| | - Pat Bedard
- Infection Prevention and Control Program, Children's Hospital of Eastern Ontario, Ottawa, Ontario, Canada
| | - Gillian Seidman
- Department of Pediatrics, University of Ottawa Faculty of Medicine, Ottawa, Ontario, Canada
- Department of Pediatrics, Children's Hospital of Eastern Ontario, Ottawa, Ontario, Canada
| | - Nisha Thampi
- Department of Pediatrics, University of Ottawa Faculty of Medicine, Ottawa, Ontario, Canada
- Infection Prevention and Control Program, Children's Hospital of Eastern Ontario, Ottawa, Ontario, Canada
- Department of Pediatrics, Children's Hospital of Eastern Ontario, Ottawa, Ontario, Canada
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