Community-Associated Clostridioides difficile Infection in Children: A Review of Recent Literature

Clostridioides difficile infection (CDI) in children is more often acquired in the community than in the hospital. Community-associated Clostridioides difficile infection (CA-CDI) cases seem to be rising, although this is confounded by the unclear role of C. difficile in children 1 and 3 years of age and overreliance on nucleic acid amplification tests for diagnosis. Exposure to antibiotics, acid suppression medications, health care settings, and close contacts with CDI are associated with CA-CDI in children. These infections are more common in children with chronic medical conditions, especially those involving the gastrointestinal tract and immune suppression. Most CA-CDI in children are mild and managed in the outpatient setting, but a small subset requires hospitalization and can be quite severe. Approximately 10% of children with CA-CDI experience a recurrence. Infection control guidance focuses on the hospital setting and future studies on the best methods for preventing community spread of C. difficile are needed.