{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,24]],"date-time":"2026-09-24T12:07:37Z","timestamp":1790251657728,"version":"4.1.0"},"reference-count":27,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2026,9,24]],"date-time":"2026-09-24T00:00:00Z","timestamp":1790208000000},"content-version":"vor","delay-in-days":266,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,1,1]],"date-time":"2026-01-01T00:00:00Z","timestamp":1767225600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pediatrics International"],"published-print":{"date-parts":[[2026,1]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>\n                      The epidemiology and clinical characteristics of pediatric\n                      <jats:italic>Clostridioides difficile<\/jats:italic>\n                      infection (CDI) in Japan have not been well characterized. Unlike in adults,\n                      <jats:styled-content style=\"fixed-case\">\n                        <jats:italic>C.\u2009difficile<\/jats:italic>\n                      <\/jats:styled-content>\n                      colonization is common in children, particularly in those younger than 2\u2009years. This study aimed to characterize pediatric CDI in Japan.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      This single\u2010center retrospective observational study included patients at Tokyo Metropolitan Children's Medical Center between April 2010 and May 2024 in whom toxigenic\n                      <jats:styled-content style=\"fixed-case\">\n                        <jats:italic>C.\u2009difficile<\/jats:italic>\n                      <\/jats:styled-content>\n                      was identified by direct stool toxin immunochromatography, toxin testing of isolates recovered by stool culture, or multiplex PCR detection of toxin A\/B gene targets. CDI was defined as laboratory evidence of toxigenic\n                      <jats:styled-content style=\"fixed-case\">\n                        <jats:italic>C.\u2009difficile<\/jats:italic>\n                      <\/jats:styled-content>\n                      with compatible gastrointestinal symptoms. Clinical data, including demographic characteristics, underlying conditions, antimicrobial exposure, treatment, severity, outcomes, and recurrence, were extracted from electronic medical records.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Among 262 patients tested, 24 were diagnosed with CDI. Fifteen (62.5%) had negative direct stool toxin tests but toxin\u2010positive isolates obtained from a stool culture. The median age was 5.5\u2009years (interquartile range: 4\u201310\u2009years); 58% of the patients were male, 75% had received antimicrobial therapy before CDI onset, and 71% had a history of hospitalization. Twelve patients (50%) received CDI\u2010directed antimicrobial therapy, and 12 patients (50%) improved without specific treatment. Fifteen patients (63%) met the study criteria for severe CDI, but only one was admitted to the pediatric intensive care unit. No recurrences were observed, and the 30\u2010day mortality rate was 0%.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Pediatric CDI had favorable outcomes, with no deaths or recurrences occurring in the present study.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/ped.70554","type":"journal-article","created":{"date-parts":[[2026,9,24]],"date-time":"2026-09-24T11:35:10Z","timestamp":1790249710000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Clinical Characteristics of Pediatric\n                    <i>Clostridioides difficile<\/i>\n                    Infection at a Children's Hospital"],"prefix":"10.1111","volume":"68","author":[{"ORCID":"https:\/\/orcid.org\/0009-0004-3348-6307","authenticated-orcid":false,"given":"Joonho","family":"Shin","sequence":"first","affiliation":[{"name":"Division of Infectious Diseases, Immunology, Department of Pediatrics Tokyo Metropolitan Children's Medical Center  Tokyo Japan"},{"name":"Center for Pediatric Infectious Diseases Tokyo Metropolitan Children's Medical Center  Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2198-2018","authenticated-orcid":false,"given":"Kenta","family":"Kuruma","sequence":"additional","affiliation":[{"name":"Division of Pediatrics Machida Municipal Hospital  Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7680-4510","authenticated-orcid":false,"given":"Hanako","family":"Funakoshi","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases, Immunology, Department of Pediatrics Tokyo Metropolitan Children's Medical Center  Tokyo Japan"},{"name":"Center for Pediatric Infectious Diseases Tokyo Metropolitan Children's Medical Center  Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1477-1415","authenticated-orcid":false,"given":"Meiwa","family":"Shibata","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases, Immunology, Department of Pediatrics Tokyo Metropolitan Children's Medical Center  Tokyo Japan"},{"name":"Center for Pediatric Infectious Diseases Tokyo Metropolitan Children's Medical Center  Tokyo Japan"},{"name":"Department of Laboratory Medicine Tokyo Metropolitan Children's Medical Center  Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5875-1024","authenticated-orcid":false,"given":"Yuho","family":"Horikoshi","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases, Immunology, Department of Pediatrics Tokyo Metropolitan Children's Medical Center  Tokyo Japan"},{"name":"Center for Pediatric Infectious Diseases Tokyo Metropolitan Children's Medical Center  Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,9,24]]},"reference":[{"key":"e_1_2_12_2_1","doi-asserted-by":"crossref","first-page":"478","DOI":"10.1038\/ajg.2013.4","article-title":"Guidelines for Diagnosis, Treatment, and Prevention of \n                     Clostridium difficile\n                   Infections","volume":"108","author":"Surawicz C. 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D.","year":"2014","journal-title":"Pediatric Infectious Disease Journal"},{"key":"e_1_2_12_11_1","doi-asserted-by":"crossref","first-page":"e1","DOI":"10.1093\/cid\/cix1085","article-title":"Clinical Practice Guidelines for \n                     Clostridium difficile\n                   Infection in Adults and Children: 2017 Update by the Infectious Diseases Society of America (IDSA) and Society for Healthcare Epidemiology of America (SHEA)","volume":"66","author":"McDonald L. 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