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Higher Mortality Rates Associated with Clostridioides difficile Infection in Hospitalized Children with Cystic Fibrosis
  • Prathipa Santhanam,
  • Matthew Egberg,
  • Michael D. Kappelman
Prathipa Santhanam
The University of North Carolina at Chapel Hill

Corresponding Author:[email protected]

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Matthew Egberg
The University of North Carolina at Chapel Hill
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Michael D. Kappelman
The University of North Carolina at Chapel Hill
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Abstract

Objective(s): To determine the impact of Clostridioides difficile Infection (CDI) among pediatric Cystic Fibrosis (CF) hospitalizations using a large nationally representative pediatric hospital database . Study design: We identified Cystic Fibrosis-related hospitalizations during the years 1997 to 2016 in the Kids’ Inpatient Database [KID] and compared in-hospital mortality, Length of Stay [LOS], and hospital charges among hospitalizations with and without a coexisting diagnosis of C. difficile using logistic regression models for mortality and general linear models with gamma distribution and logarithmic transformation for LOS and hospital charges. We also evaluated temporal trends in the proportion of CF hospitalizations with concomitant CDI using data published triennially Results: We analyzed 21, 616 pediatric CF hospitalizations between the years 1997 to 2016 and found a total of 240 (1.1%) hospitalizations with concurrent CDI diagnosis. Adjusted analyses demonstrated an association of CDI with increased mortality (OR 5.2, 95% 95% CI 2.5-10.7), longer LOS (46.5% increment, 95% CI 36.0-57.1), and higher charges (65.8% increment, 95% CI 53.5-78.1) for all comparisons. The proportion of CF hospitalizations with CDI increased over time from 0.64% in 1997 to 1.73% in 2016 (p<0.001). Conclusion(s): As CDI is associated with excess mortality, LOS, and cost in children hospitalized for CF, efforts to reduce infection rates and aggressive diagnosis and treatment of active infections should be prioritized to improve hospital outcomes among children with CF.
07 Apr 2022Submitted to Pediatric Pulmonology
07 Apr 2022Submission Checks Completed
07 Apr 2022Assigned to Editor
11 Apr 2022Reviewer(s) Assigned
19 Apr 2022Review(s) Completed, Editorial Evaluation Pending
13 May 2022Editorial Decision: Revise Major
27 May 20221st Revision Received
31 May 2022Submission Checks Completed
31 May 2022Assigned to Editor
31 May 2022Reviewer(s) Assigned
16 Jun 2022Review(s) Completed, Editorial Evaluation Pending
16 Jun 2022Editorial Decision: Revise Minor
21 Jun 20222nd Revision Received
05 Jul 2022Submission Checks Completed
05 Jul 2022Assigned to Editor
05 Jul 2022Reviewer(s) Assigned
25 Jul 2022Review(s) Completed, Editorial Evaluation Pending
25 Jul 2022Editorial Decision: Revise Minor
01 Aug 20223rd Revision Received
24 Aug 2022Submission Checks Completed
24 Aug 2022Assigned to Editor
24 Aug 2022Reviewer(s) Assigned
18 Sep 2022Review(s) Completed, Editorial Evaluation Pending
28 Sep 2022Editorial Decision: Accept
18 Nov 2022Published in Pediatric Pulmonology. 10.1002/ppul.26214