For a study, researchers sought to examine the frequency of hospitalizations for Clostridioides difficile infection (CDI) in children with inflammatory bowel disease (IBD). Investigators compared the risk of hospitalization with CDI in children with and without IBD using health administrative data and validated algorithms. They looked at all children (<16 years) diagnosed with IBD in 5 Canadian provinces, then age and sex-matched to 5 children without IBD. Province-specific The crude incidence rate ratio (IRR) comparing children with and without IBD and children with Crohn’s disease and ulcerative colitis was calculated using 5-year incidence rates of hospitalization with CDI and generalized linear mixed-effects models. Fixed-effects models were used to pool the hazard ratios (HR) from Cox proportional hazards models that included age, sex, rural/urban household, and income adjustments. In 3593 children with IBD, the incidence rate of CDI diagnosed during hospitalization was 49.06 (95% (CI), 39.40-61.08), compared to 0.39 (95% CI, 0.13-1.21) per 10,000 PY in 16,284 children without IBD (crude IRR, 133.4, 95% CI, 42.1–422.7; adjusted HR, 68.2, 95% CI, 24.4–190.4). The incidence of CDI was found to be less common in children with Crohn’s disease than in children with ulcerative colitis (crude IRR, 0.51, 95% CI, 0.32–0.82; adjusted HR, 0.69, 95% CI, 0.46–1.05). (This was measured by the crude IRR, which measures how often something happens in two groups of people.) However, when hospitalized, children with IBD are much more likely to have CDI detected than children without IBD. Therefore, all symptomatic children with IBD who are hospitalized should be screened for CDI.
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