[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"detail-sidebar-cat-0-en-105":3,"doc-seo-449401-105":59,"doc-detail-449401-en":130},{"code":4,"msg":5,"data":6},0,"success",[7,13,18,23,28,33,38,43,48,51,55],{"id":8,"doc_module":4,"doc_module_name":9,"category_name":10,"show_sort_weight":11,"slug":12},1,"Document","Story & Novel",90,"story-novel",{"id":14,"doc_module":4,"doc_module_name":9,"category_name":15,"show_sort_weight":16,"slug":17},2,"Literature",80,"literature",{"id":19,"doc_module":4,"doc_module_name":9,"category_name":20,"show_sort_weight":21,"slug":22},4,"Exam",70,"exam",{"id":24,"doc_module":4,"doc_module_name":9,"category_name":25,"show_sort_weight":26,"slug":27},5,"Comic",60,"comic",{"id":29,"doc_module":4,"doc_module_name":9,"category_name":30,"show_sort_weight":31,"slug":32},6,"Technology",50,"technology",{"id":34,"doc_module":4,"doc_module_name":9,"category_name":35,"show_sort_weight":36,"slug":37},7,"Healthcare",40,"healthcare",{"id":39,"doc_module":4,"doc_module_name":9,"category_name":40,"show_sort_weight":41,"slug":42},8,"Research & Report",30,"research-report",{"id":44,"doc_module":4,"doc_module_name":9,"category_name":45,"show_sort_weight":46,"slug":47},9,"Religion & Spirituality",20,"religion-spirituality",{"id":46,"doc_module":4,"doc_module_name":9,"category_name":49,"show_sort_weight":46,"slug":50},"World Cup","world-cup",{"id":52,"doc_module":4,"doc_module_name":9,"category_name":53,"show_sort_weight":52,"slug":54},10,"Lifestyle","lifestyle",{"id":56,"doc_module":4,"doc_module_name":9,"category_name":57,"show_sort_weight":24,"slug":58},19,"General","general",{"code":4,"msg":60,"data":61},"ok",{"site_id":62,"language":63,"slug":64,"title":65,"keywords":66,"description":67,"schema_data":68,"social_meta":123,"head_meta":125,"extra_data":127,"updated_unix":129},105,"en","the-prevalence-and-molecular-epidemiology-of-clostridioides-difficile-in-hospital-based-pediatric-populations-in-china","The prevalence and molecular epidemiology of Clostridioides difficile in hospital-based pediatric populations in China","","A multicenter cross-sectional study across six Chinese hospitals (Sep 2023–Apr 2024) evaluated the prevalence, molecular epidemiology, antimicrobial resistance (AMR), and genetic relatedness of Clostridioides difficile in pediatric patients. Among 1,442 stool samples, 242 isolates were recovered (16.8%): 188 from asymptomatic carriers (13.0%) and 11 from confirmed CDI cases (0.98%). ST3 predominated (30.6%), core-genome phylogeny showed nine lineages, and CDI-associated lineage VI was most common.",{"@graph":69,"@context":122},[70,84,105],{"@type":71,"itemListElement":72},"BreadcrumbList",[73,77,79,82],{"item":74,"name":75,"@type":76,"position":8},"https://docshare.wps.com","Home","ListItem",{"item":78,"name":9,"@type":76,"position":14},"https://docshare.wps.com/document/",{"item":80,"name":35,"@type":76,"position":81},"https://docshare.wps.com/document/healthcare/",3,{"item":83,"name":65,"@type":76,"position":19},"https://docshare.wps.com/document/the-prevalence-and-molecular-epidemiology-of-clostridioides-difficile-in-hospital-based-pediatric-populations-in-china/449401/",{"url":83,"name":65,"@type":85,"image":86,"author":91,"headline":65,"publisher":94,"fileFormat":97,"inLanguage":63,"description":67,"dateModified":98,"datePublished":99,"encodingFormat":97,"isAccessibleForFree":100,"interactionStatistic":101},"DigitalDocument",{"url":87,"@type":88,"width":89,"height":90},"https://docshare.wps.com/thumbnails/the-prevalence-and-molecular-epidemiology-of-clostridioides-difficile-in-hospital-based-pediatric-populations-in-china/449401.png","ImageObject",300,407,{"name":92,"@type":93},"Guten tag","Person",{"url":74,"name":95,"@type":96},"DocShare","Organization","application/pdf","2026-11-02","2026-09-30",true,{"@type":102,"interactionType":103,"userInteractionCount":44},"InteractionCounter",{"@type":104},"ViewAction",{"@type":106,"mainEntity":107},"FAQPage",[108,114,118],{"name":109,"@type":110,"acceptedAnswer":111},"What study design and timeframe were used to assess C. difficile in pediatric patients?","Question",{"text":112,"@type":113},"A multicenter cross-sectional study was conducted in six hospitals across China from September 2023 to April 2024.","Answer",{"name":115,"@type":110,"acceptedAnswer":116},"What proportion of stool samples yielded C. difficile isolates, and how were they classified?",{"text":117,"@type":113},"Out of 1,442 stool samples, 242 isolates were recovered (16.8%). Of these, 188 were from asymptomatic carriers (13.0%) and 11 from confirmed CDI cases (0.98%).",{"name":119,"@type":110,"acceptedAnswer":120},"Which antimicrobial resistance patterns and mechanisms were most prominent?",{"text":121,"@type":113},"High resistance to clindamycin (64.5%) was observed, primarily mediated by ermB, while all isolates remained susceptible to metronidazole and vancomycin. Moxifloxacin resistance (10.7%) was associated with gyrA T82I mutations, especially in toxigenic ST3 strains.","https://schema.org",{"og:url":83,"og:type":124,"og:title":65,"og:site_name":95,"og:description":67},"article",{"robots":126,"canonical":83},"index,follow",{"doc_id":128,"site_id":62},449401,1791093480,{"code":4,"msg":5,"data":131},{"doc_id":128,"user_id":132,"nickname":92,"user_avatar":133,"doc_module":4,"category_id":34,"category_name":35,"doc_title":65,"doc_description":67,"doc_content":134,"file_id":135,"file_url":136,"file_type":137,"file_size":138,"view_count":44,"is_deleted":4,"is_public":8,"is_downloadable":8,"audit_status":8,"page_count":139,"language":140,"language_code":63,"site_id":62,"html_lang":63,"table_of_contents":141,"faqs":142,"seo_title":143,"seo_description":67,"update_tm":144,"read_time":36,"preview_page_count":4},687212321768,"https://ap-avatar.wpscdn.com/avatar/a0010bdbe886d2fe77?x-image-process=image/resize,m_fixed,w_180,h_180&k=1789897067658708522","Emerging Microbes & Infections  \n2026, VOL. 15, 2602319 (16 pages) [https://doi.org/10.1080/22221751.2025.2602319](https://doi.org/10.1080/22221751.2025.2602319)  \nThe prevalence and molecular epidemiology of Clostridioides difficile in hospital-based pediatric populations in China  \nYu Zenga, b*, Yining Shena*, Fangfang Fana, b*, Yiyue Liua, Tongxuan Sua, Qianli Zhaoa, Wei Chena, Cen Jianga, Qi Nia, Ru Fana, Manyuan Lic, Danfeng Donga and Yibing Penga, b  \naDepartment of Laboratory Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China; bCollege of Health Science and Technology, Shanghai Jiao Tong University School of Medicine, Shanghai, China; cDepartment of Laboratory Medicine, Jinzhou Maternal and Infant Hospital, Liaoning, China  \nABSTRACT  \nA multicenter cross-sectional study was conducted across six Chinese hospitals between September 2023 and April 2024 to investigate the prevalence, molecular epidemiology, antimicrobial resistance (AMR) and genetic relatedness of C. difficile in pediatric populations. Among 1,442 stool samples collected, 242 C. difficile isolates were recovered (16.8%), including 188 from asymptomatic carriers (13.0%) and 11 from confirmed C. difficile infection (CDI) cases (0.98%) . The highest rate of asymptomatic carriage was observed in children aged 1–2 years (29.3%) . Multilocus sequence typing (MLST) identified ST3 as the predominant sequence type (30.6%), followed by ST42, ST54, ST2, ST102, and ST110 . Core genome phylogenetic analysis revealed nine distinct genetic lineages, with lineage VI being the most prevalent among CDI cases. High resistance to clindamycin (64.5%) was observed, primarily mediated by ermB, while all isolates remained susceptible to metronidazole and vancomycin. Moxifloxacin resistance (10.7%) was associated with gyrA T82I mutations, particularly in toxigenic ST3 strains. Transposon analysis indicated ST-specific carriage of AMR genes, with Tn6218(ermB) prevalent in nontoxigenic ST3 isolates and Tn5801 (tet(M)) predominant in ST54 . Genomic relatedness (≤2 SNPs) was detected in 12.0% of asymptomatic carriers, with most links associated with hospital-wide contact, suggesting possible transmission events. This study highlights the importance of asymptomatic colonized children as a reservoir for C. difficile, maintaining resistant lineages and disseminating AMR,  \nthereby underscoring the need for enhanced surveillance and targeted antimicrobial stewardship in Chinese healthcare settings.  \nARTICLE HISTORY Received 13 March 2025; Revised 5 November 2025; Accepted 7 December 2025 KEYWORDS CDI; asymptomatic carriage; pediatric; AMR; genetic relatedness  \nIntroduction  \nClostridioides difficile, a Gram-positive, spore-forming anaerobe, has emerged as a leading cause of antibioticassociated diarrhea with significant global burden [ 1] . Its pathogenicity primarily stems from exotoxins TcdA and TcdB, which disrupt intestinal epithelial integrity through cytoskeletal damage and inflammatory cascades [2] . Strains producing binary toxin (CDT) further exacerbate virulence by inducing actin depolymerization [3], collectively driving disease manifestations ranging from self-limiting diarrhea to  \nlife-threatening pseudomembranous colitis [4] .  \nWhile traditionally regarded as a nosocomial pathogen in adults, CDI incidence in pediatric populations has risen globally [5–8] . Pediatric cases demonstrate distinct epidemiology characterized by higher community-onset infection rates and limited outbreak clustering. Molecular analyses reveal geographically  \nstratified ribotype distributions, with RT014/020 and RT106 predominating in Western cohorts while RT001 (ST3), RT012 (ST54), RT039 (ST26), and RT046 (ST35) prevail across Asian populations [7,9– 13] . Notably, the epidemic ribotype RT027 (ST1), which predominates in adult healthcare outbreaks, is rarely detected in children [ 13] . Critically, documented correlations between the geographic distribu","cbCaiac3esJyjvEr","https://ap.wps.com/l/cbCaiac3esJyjvEr","pdf",1571872,16,"English","# Abstract\n## Study design and sampling\n## Prevalence and colonization patterns\n## Molecular typing and phylogenetics\n## Antimicrobial resistance findings\n## AMR gene carriage and transmission signals\n# Introduction\n## Pathogenesis and toxins\n## Pediatric epidemiology versus adults\n## Diagnostic challenges and guideline context","[{\"question\":\"What study design and timeframe were used to assess C. difficile in pediatric patients?\",\"answer\":\"A multicenter cross-sectional study was conducted in six hospitals across China from September 2023 to April 2024.\"},{\"question\":\"What proportion of stool samples yielded C. difficile isolates, and how were they classified?\",\"answer\":\"Out of 1,442 stool samples, 242 isolates were recovered (16.8%). Of these, 188 were from asymptomatic carriers (13.0%) and 11 from confirmed CDI cases (0.98%).\"},{\"question\":\"Which antimicrobial resistance patterns and mechanisms were most prominent?\",\"answer\":\"High resistance to clindamycin (64.5%) was observed, primarily mediated by ermB, while all isolates remained susceptible to metronidazole and vancomycin. Moxifloxacin resistance (10.7%) was associated with gyrA T82I mutations, especially in toxigenic ST3 strains.\"}]","The prevalence and molecular epidemiology of Clostridioides difficile in hospital-based pediatric populations in China | PDF",1790730128]