Clostridioides difficile is a well-recognized healthcare-associated pathogen, with its significance widely recognized in adult populations. Despite this, there is limited data on the significance of detection within paediatric populations, both for individual patient management and wider transmission risk-based considerations. High rates of colonization are understood to occur in infants, with increasing levels up to 11 months, and colonization rates similar to adults by 8 years old. Sources of C. difficile are ubiquitous, with detection in companion animals and food sources, as well as within the clinical and wider environment. Due to the close interactions that occur between children and the environment, it is understandable that increasing recognition is afforded to the community acquisition of C. difficile in children. Other risk factors for the detection of C. difficile in children are similar to those observed in adults, including prior hospitalization and underlying conditions affecting gut health and motility. Recent studies have shown rising awareness of the role of asymptomatic carriage of C. difficile in healthcare transmission. Prior to this, paediatric patient populations were less likely to be screened due to uncertainty regarding the significance of detection; however, this increased awareness has led to a review of possible carriage testing pathways. Despite this increased attention, C. difficile infection remains poorly defined in paediatric populations, with limited dedicated paediatric data sets making comparison challenging. This is further complicated by the fact that infection in children frequently self resolves without additional therapies. Due to this, C. difficile remains a management challenge in paediatric settings.

中文翻译：

---

儿童中艰难梭菌的检测和感染：他们只是小成年人吗？

艰难梭菌是一种公认​​的医疗保健相关病原体，其重要性在成年人中得到广泛认可。尽管如此，关于儿科人群中检测的重要性的数据有限，无论是对于个体患者管理还是更广泛的基于传播风险的考虑。据了解，婴儿的定植率很高，直至 11 个月时水平不断增加，到 8 岁时定植率与成人相似。艰难梭菌的来源无处不在，可在伴侣动物和食物来源以及临床和更广泛的环境中检测到。由于儿童与环境之间发生密切的相互作用，人们越来越认识到儿童中艰难梭菌的社区感染是可以理解的。儿童中检测到艰难梭菌的其他危险因素与成人中观察到的相似，包括既往住院史和影响肠道健康和蠕动的潜在疾病。最近的研究表明，人们越来越意识到无症状携带艰难梭菌在医疗传播中的作用。在此之前，由于检测意义的不确定性，儿科患者群体不太可能接受筛查；然而，这种认识的提高导致了对可能的运输测试途径的审查。尽管受到越来越多的关注，但艰难梭菌感染在儿科人群中的定义仍然不明确，专门的儿科数据集有限，使得比较具有挑战性。由于儿童感染常常无需额外治疗即可自行消退，这一事实使情况变得更加复杂。因此，艰难梭菌仍然是儿科环境中的管理挑战。