Clostridium difficile Colonization in Asymptomatic Infants 1 to 12 Months Old, Admitted to a Community Hospital

Prevalence of Detection of Clostridioides difficile Among Asymptomatic Children

“…Age groups included neonates (n = 13); infants (n = 24); and children 2 years or younger (n = 12), 3 years or younger (n = 3), 5 years or younger (n = 2), 8 years or younger (n = 2), 10 years or younger (n = 1), and older than 10 years (n = 32) . Seventy-seven studies included healthy children; other populations were premature or low-birth-weight infants (n = 6), patients with oncologic or hematologic disease (n = 9), patients with a diagnosis of malnourishment (n = 1), and outpatients attending gastroenterology clinics without C difficile –associated clinical symptoms (n = 2) (eTable 2 in the Supplement).…”

“…Fifty-three studies (55%) had no unclear items or items at risk of bias and thus were considered low risk-of-bias studies . Fifteen studies had a high risk of bias because the samples were not representative of the target population (eg, special populations) (eTable 3 in the Supplement).…”

“…Fifteen studies had a high risk of bias because the samples were not representative of the target population (eg, special populations) (eTable 3 in the Supplement). Most studies had either low (n = 88) or unclear (n = 5) risk of bias with regard to participant recruitment.…”

“…Studies that fully (n = 80) or partially (n = 4) described the participants and setting were at low and unclear risk of bias, respectively. Eleven studies had a high risk of bias because of failure to describe the participants or setting in detail (eg, hospitalized children without admission diagnoses) …”

“…We compared the overall prevalence of C difficile detection according to geographic region: Africa (n = 5), North and South America (n = 25), Southeast Asia (n = 3), Eastern Mediterranean (n = 6), Europe (n = 40), and Western Pacific (n = 16) . Prevalence was also compared by income status: high income (n = 71), upper-middle income (n = 16), lower-middle income (n = 7), and low income (n = 1) . Overall, the prevalence in North and South America differed from that in Europe (β, −0.151; P = .001) and the Western Pacific (β, 0.136; P = .008) regions (Figure 3A).…”