A262 CLOSTRIDIUM DIFFICILE INFECTION IN CHILDREN WITH INFLAMMATORY BOWEL DISEASE: A SINGLE CENTER CROSS-SECTIONAL STUDY
Bibliographic record
Abstract
Many studies have reported a high incidence of Clostridium difficile infections (CDI) among patients with inflammatory bowel disease (IBD). It was also suggested that CDI occurrence and recurrence in IBD pediatric patients have been increasing in the last decades. The aim of this study was to assess the incidence and prevalence of CDI and to identify the associated risk factors in children diagnosed with IBD. This cross-sectional study included all children diagnosed with IBD between January 2011 and September 2018. CDI diagnosis was confirmed by the presence of Clostridium difficile toxin, detected by a cellular cytotoxicity test (before 2014) or Polymerase Chain Reaction test (after 2014). CDI at diagnosis was defined as a positive test seven days before or after IBD diagnosis. CDI prevalence was estimated according to the total number of patients and of CDI cases. Incidence was calculated according to the number of children exposed and follow-up days. Factors associated with CDI occurrence were investigated. During the study period, 767 patients (375 females) were diagnosed with IBD. The mean (SD) age at diagnosis was 13.1 (± 4.1) years old. Of these, 499 patients were diagnosed with Crohn’s disease (CD) (65.1%), 163 (21.2%) with ulcerative colitis (UC) and 105 (13.7%) with IBD unclassified (IBDU). A total of 43 (5.6%) patients had at least one episode of CDI, including 12 (1.6%) at diagnosis and 34 (4.4%) after diagnosis. Children who had at least one CDI were significantly younger at diagnosis (mean (SD) age 11.9 (± 4.1) years), as compared to those who were never infected (13.2 (± 3.4) years, P= 0.013). The rate of CDI was not different between females (6.7%) and males (4.6%) (P=0.402). CDI prevalence was higher in UC (11.7%) than CD (3.4%) or IBDU (6.7%) (P=0.0005). CDI recurrence was observed in 18.6% of children, with no significant difference according to age at diagnosis (P=0.219), sex (P=0.782) or diagnosis (P=0.212). For UC or IBDU patients with at least one episode of CDI (N = 26), 17 (65.4%) of them had pancolitis, compared to 9 (34.6%) with left side colitis/proctitis (P=0.002). In multivariate analysis, children were more likely to have CDI during follow-up if, at diagnosis, they had a pancolitis (OR=4.1, 95% CI: 1.6 – 10.5, P=0.003), an episode of CDI (OR=5.4, 95% CI: 1.2 – 24.2, P=0.027) and age < 10 years (OR=2.5, 95% CI: 1.2 – 5.4, P=0.016). Crohn’s colitis was associated with a higher prevalence of CDI as compared to isolated ileitis (5.0% and 1.0% respectively, P=0.021). The prevalence of CDI in our cohort (5.6%) falls within the range that is described in the literature. A young age at diagnosis, colitis in CD, pancolitis in CU and a history of CDI at diagnosis were found to be risk factors for CDI in children with IBD. None
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.002 |
| Meta-epidemiology (narrow) | 0.000 | 0.001 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.001 | 0.002 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.000 | 0.001 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.002 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".