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Clostridium difficile associated disease in hospitalized children in the United States

Nylund, Cade McCoy
http://rave.ohiolink.edu/etdc/view?acc_num=ucin1281450532

Abstract Details

2010, MS, University of Cincinnati, Medicine: Clinical and Translational Research.
Background: Clostridium difficile associated disease (CDAD) can lead to prolonged hospital course, colectomy and death. In previous epidemiological studies there is evidence that the national rate and severity of CDAD are increasing. Little is known about the risks and impact of CDAD in children. Objective: To evaluate epidemiology, and risk factors of CDAD in hospitalized children in the United States Design: The Healthcare Cost and Utilization Project Kids’ Inpatient Database (KID) was utilized to design a retrospective cohort study of hospitalized children in the United States over four time periods:1997, 2000, 2003, and 2006. Outcome measures: Trends in national cases of CDAD. Severity was measured by length of stay, hospital costs, colectomy rate and case fatality rate. Results: The total discharges were 10,495,728 and those with CDAD were 21,274 over the four time periods. There was an increasing trend in CDAD (p<.0001).There was no trend in length of stay, colectomy rate or case fatality rate associated with CDAD over the four time periods. CDAD in children is associated with an increased risk of death, colectomy, longer length of stay and higher charges. Multivariate logistic regression results evaluating risk comorbid diagnoses associated with CDAD demonstrate a high risk in inflammatory bowel disease, odd ratio (95% CI) of 11.42 (10.16-12.83) and other comorbid diagnoses associated with immunosuppression, or with antibiotic administration. Conclusion: There is an increasing trend of hospitalized children with CDAD. In contrast to adults, there is no increasing trend in the severity of CDAD in children. Children with certain medical conditions including IBD, immunosupression, or conditions requiring antibiotic administration are at high risk of CDAD.
Marepalli Rao, PhD (Committee Chair)
Lee Denson, MD (Committee Member)
Ardythe Morrow, PhD (Committee Member)
30 p.
Epidemiology
clostridium difficile; pediatric; children

Recommended Citations

Citations

  • Nylund, C. M. (2010). Clostridium difficile associated disease in hospitalized children in the United States [Master's thesis, University of Cincinnati]. OhioLINK Electronic Theses and Dissertations Center. http://rave.ohiolink.edu/etdc/view?acc_num=ucin1281450532

    APA Style (7th edition)

  • Nylund, Cade. Clostridium difficile associated disease in hospitalized children in the United States. 2010. University of Cincinnati, Master's thesis. OhioLINK Electronic Theses and Dissertations Center, http://rave.ohiolink.edu/etdc/view?acc_num=ucin1281450532.

    MLA Style (8th edition)

  • Nylund, Cade. "Clostridium difficile associated disease in hospitalized children in the United States." Master's thesis, University of Cincinnati, 2010. http://rave.ohiolink.edu/etdc/view?acc_num=ucin1281450532

    Chicago Manual of Style (17th edition)

ucin1281450532
482
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This open access ETD is published by University of Cincinnati and OhioLINK.