Neonatal Clostridioides difficile infections – facts and myths
Authors:
Z. Vojteková; J. Kuchárová
Authors‘ workplace:
Perinatologické centrum – oddelenie neonatológie, FNsP J. A. Reimana, Prešov
Published in:
Čes-slov Neonat 2026; 32 (1): 34-43.
Category:
Original Paper
Overview
Infections caused by toxigenic Clostridioides difficile strains are among the most common causes of nosocomial intestinal infections in the adult population and, to some extent, also in pediatric patients. The spectrum of clinical manifestations can vary in severity – from mild diarrhea to life-threatening conditions such as paralytic ileus, toxic megacolon, and secondary bacterial sepsis. Within the medical community, there has long been a prevailing opinion that, unlike in adults, Clostridioides infection do not result in clinically significant disease in neonates. However, sporadic but increasingly reported case studies, along with our own clinical observations, suggest that clinically severe, symptomatic clostridial enterocolitis in neonates and young infants is not merely a myth, but an emerging reality. Despite current guidelines discouraging routine testing for C. difficile in children under 2 years of age, infection may be considered in individual high-risk neonates presenting with prolonged gastrointestinal symptoms, including bloody diarrhea, after excluding more likely causes. The aim of this article is to map the development of the neonatal gut microbiome and its relationship to Clostridioides difficile infection, determine its prevalence in this population, and describe the spectrum of clinical manifestations as well as the latest diagnostic and treatment options. We present two case reports of patients with suspected Clostridioides difficile infection from our department.
Keywords:
Clostridioides difficile – newborn – Clostridioides difficile infection – vankomycin – metronidazol – neonatal gut microbiome
Sources
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Czech and Slovak Neonatology
2026 Issue 1
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