臨床感染症と実践

抽象的な

Risk Factors Associated with Clostridium difficile Infection in a Pediatric Hematology-Oncology Ward with Analysis of the Infection Control Measures

Zainab Al-Musa ,Mahmoud Shorman *

Introduction: The impact of clostridium difficile infection (CDI) on patients’ health and hospitals’ cost is significant. Currently CDI is recognized as an increasingly important pathogen in children with increasing incidence among pediatric patients. Data is scarce on the incidence and risk factors of CDI in Saudi Arabia, especially in pediatric oncology population. In this study, we report the first outbreak of CDI in pediatric hematology-oncology ward in Saudi Arabia and describe the associated risk factors for CDI.

Methods: This is a descriptive, epidemiologic hospital based case-control study of pediatric Patients in hematology-oncology ward who had CDI in an outbreak from January 2012 to June 2013 at a tertiary hospital in Saudi Arabia, matched randomly to a control group who were admitted in the same ward during the study period. The main outcome measure was the adjusted odds ratio estimates of potential risk factors for CDI infection. We also describe the control measures that were implemented to control this outbreak.

Results: Risk factors associated with CDI were antibiotic use with cotrimoxazole being the most used one, and length of hospital stay. Controls were found to have been treated more with penicillins and aminoglycosides.

Conclusion: Factors associated with CDI infection are often complex and maybe confounded by local variables, antibiotic exposure and lengthy hospital stays are among many risk factors for CDI in high -risk populations. Our study also highlights the importance of infection control measures in controlling and preventing outbreaks of CDI.