Abstract Aim Clostridioides difficile is considered a constituent of the intestinal microbiota, but C. difficile -associated diarrhea (CDAD) is one of the main causes of healthcare-associated infections (HAIs). Objectives This study aimed to assess the prevalence of Clostridioides difficile infection, identify associated clinical variables, and describe specific treatment strategies in a Brazilian pediatric hospital. Methods Study design, this is a case–control study conducted by active surveillance of patients aged between 0 and 18 years admitted and treated as a suspected case of C. difficile infection (CDI). Participant selection, we included 251 children and adolescents with clinical suspicion of CDI, of which 62 (24.7%) had toxins A and/or B or glutamate dehydrogenase (GDH) detected in fecal samples. Statistical techniques, the variables were categorized and quantified by frequency percentage, and the chi-square statistical test (X 2 ) was used to compare the proportions, with p < 0.05 as the threshold of statistical significance. Results The variables associated with infection were hypoalbuminemia ( p = 0.047), previous inflammatory disease ( p = 0.005), altered radiological image ( p = 0.026), and hemodynamic instability ( p = 0.003) during colitis. The clinical outcomes were death ( p = 0.034), recurrence ( p < 0.001), and persistence of diarrhea ( p = 0.001) and toxins A and/or B ( p = 0.007) in fecal samples. Conclusions In conclusion, although the incidence of CDI and the associated mortality in Minas Gerais are relatively low in the national context, they remain higher than the rates reported in the United States and Europe, our findings reinforced the importance of active surveillance of this infection, particularly in patients with risk factors, and implementation of stricter preventive measures to contain CDI in a hospital environment.
Soares et al. (Mon,) studied this question.