{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,21]],"date-time":"2026-10-21T18:40:56Z","timestamp":1792608056359,"version":"4.5.0"},"reference-count":43,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,9,17]],"date-time":"2026-09-17T00:00:00Z","timestamp":1789603200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,9,17]],"date-time":"2026-09-17T00:00:00Z","timestamp":1789603200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J. pediatr. gastroenterol. nutr."],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>\n                      Children with inflammatory bowel disease (IBD) are at increased risk for\n                      <jats:italic>Clostridioides difficile<\/jats:italic>\n                      infection (CDI), which is associated with worse clinical outcomes. We aimed to assess current diagnostic and therapeutic practices for CDI among Italian pediatric IBD centers.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A nationwide survey was conducted in 2025 using a structured 28\u2010item questionnaire distributed to all pediatric IBD centers in Italy. Items addressed diagnostic strategies, treatment approaches, recurrence management, and immunosuppressive therapy handling in children with IBD and CDI.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Twenty\u2010seven centers responded (response rate, 90%). Diagnostic approaches varied: toxin enzyme immunoassays (EIA) were indicated by 21\/27 centers (78%), glutamate dehydrogenase (GDH) testing by 19\/27 (70%), and nucleic acid amplification tests (NAAT) by 13\/27 (48%). Routine CDI testing at IBD diagnosis was indicated by 12\/27 centers (44%), whereas 23\/27 (85%) reported testing during IBD flares. For a first non\u2010severe episode, vancomycin and metronidazole were equally identified as preferred first\u2010line options (18\/27; 66% each). Oral vancomycin was the preferred treatment for recurrent CDI (26\/27; 96%). Third or subsequent recurrences prompted consideration of fidaxomicin (19\/27; 70%), fecal microbiota transplantation (6\/27; 22%), and bezlotoxumab (2\/27; 7%). In fulminant CDI, 7\/27 centers (26%) indicated adding fidaxomicin to standard therapy. In acute severe colitis with concomitant CDI at diagnosis, 18\/27 centers (67%) described a cautious approach to biologic initiation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>This nationwide survey highlights substantial unmet needs in CDI management in pediatric IBD, including variability in diagnostic strategies, lack of consensus on first\u2010line therapy, and uncertainty regarding immunosuppressive management, supporting the need for evidence\u2010based pediatric\u2010specific guidelines.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/jpn3.70575","type":"journal-article","created":{"date-parts":[[2026,9,18]],"date-time":"2026-09-18T04:31:58Z","timestamp":1789705918000},"source":"Crossref","is-referenced-by-count":0,"title":["Current practices and unmet needs in the management of\n                    <i>Clostridioides difficile<\/i>\n                    infection in pediatric inflammatory bowel disease: A national survey"],"prefix":"10.1002","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1209-8562","authenticated-orcid":false,"given":"Anastasiia","family":"Romanchuk","sequence":"first","affiliation":[{"name":"Paediatric Hepatology Gastroenterology and Transplantation Hospital Papa Giovanni XXIII Bergamo Italy"},{"name":"Department of Pediatrics, Neonatology, Pediatric Infectious Diseases, Immunology, and Allergology Shupyk National Healthcare University of Ukraine Kyiv Ukraine"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5249-8248","authenticated-orcid":false,"given":"Matteo","family":"Bramuzzo","sequence":"additional","affiliation":[{"name":"Institute for Maternal and Child Health IRCCS \u201cBurlo Garofolo\u201d Trieste Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Flavio","family":"Labriola","sequence":"additional","affiliation":[{"name":"Pediatric Gastroenterology Unit Maggiore \u201cCA Pizzardi\u201d Hospital Bologna Bologna Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7404-4004","authenticated-orcid":false,"given":"Marina","family":"Aloi","sequence":"additional","affiliation":[{"name":"Pediatric Gastroenterology, Hepatology and Cystic Fibrosis Unit, Department of Pathophysiology and Transplantation Universit\u00e0 degli Studi di Milano, Fondazione IRCCS C\u00e0 Granda, Ospedale Maggiore Policlinico di Milano Milan Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Claudia","family":"Banzato","sequence":"additional","affiliation":[{"name":"University Hospital of Verona Verona Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7991-3050","authenticated-orcid":false,"given":"Luca","family":"Bosa","sequence":"additional","affiliation":[{"name":"University Hospital of Padova Padua Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Antonio","family":"Colucci","sequence":"additional","affiliation":[{"name":"University of Campania \u201cLuigi Vanvitelli\u201d Naples Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-9459-7643","authenticated-orcid":false,"given":"Mara","family":"Corpino","sequence":"additional","affiliation":[{"name":"Ospedale Pediatrico Microcitemico A. 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