{"doi":"10.1093/jpids/piab090","title":"<i>Clostridioides difficile</i> Infection in Children: Research Progress, Pitfalls, and Priorities","abstract":"Pediatricians and scientists who are focused on child health are continually reminded that “children are not small adults.” We revel in the amazing resilience of children as they recover from injuries and illness; we relentlessly advocate for child health and well-being; we identify unmet needs in pediatric clinical care and research; and we meticulously design and implement scientific investigation, from bench to bedside, to address these unmet needs. We also critically appraise research findings in adults to assess what is broadly applicable to children, thoughtfully identifying knowledge gaps in children to identify priorities for future investigation. In adults, our understanding of the pathogenesis, epidemiology, diagnosis, treatment, and prevention of Clostridioides difficile infection (CDI) has expanded widely over the past two decades, driven by a global commitment to combat a pathogen that the US Centers for Disease Control and Prevention has deemed an urgent public health threat that requires aggressive action [1]. Despite pediatric CDI increasing in frequency over the past decade [2], and with increasing morbidity related to frequent recurrences [3], expansion of knowledge of pediatric CDI has lagged in pace and breadth relative to adults. However, pediatric CDI research has accelerated in recent years. This has led to several salient clinical benchmarks, such as dedicated pediatric CDI management guidance from professional societies [4]; the first drug approved by the US Food and Drug Administration for CDI treatment in children [5]; and expansion of fecal microbiota transplantation as a safe and effective CDI treatment in children [3]. In this supplemental issue of the Journal of the Pediatric Infectious Diseases Society (JPIDS), experts in the investigation and clinical care of CDI in children in the United States and abroad summarize the current knowledge regarding various aspects of CDI in children through a series of concise review articles. These include pathogenesis of CDI related to the microbiome and the host immune response; clinical and molecular epidemiology of CDI in children; CDI in specific high-risk patient populations; CDI diagnosis and treatment; and CDI prevention through infection control and antimicrobial stewardship efforts. Through their efforts, current gaps in pediatric CDI knowledge and unmet needs in clinical care are identified. Drawing from the perspectives of the authors in this JPIDS pediatric CDI supplemental issue, we the editors propose several priorities for future pediatric CDI investigation in the basic science, translational, and clinical spaces (Table 1). It is our intention to generate interest, collaboration, and implementation in these proposed areas of research to accelerate the development of new strategies for improving care of children experiencing CDI. Priorities for Future Pediatric CDI Investigation Supplement sponsorship. This supplement was sponsored by Pfizer, Merck, and Azurity. Potential conflicts of interest. L. K. K. has received research support from Merck, unrelated to the content of this work. C. A. D. B. has received research support from bioMerieux, Cepheid, BioFire, and Luminex and speaker fees from Roche and bioMerieux. M. R. N. reports consulting fees from Summit Therapeutics. J. P. Z. has received research grant support from BioNTech. All authors have submitted the ICMJE Form for Potential Conflicts of Interest. Conflicts that the editors consider relevant to the content of the manuscript have been disclosed.","journal":"Journal of the Pediatric Infectious Diseases Society","year":2021,"id":209607,"datarank":0.0,"base_score":0.0,"endowment":0.0,"self_citation_contribution":0.0,"citation_network_contribution":0.0,"self_endowment_contribution":0.0,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":3,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.9553,"is_data_producer":false,"deposit_databanks":null,"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2021-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":246794,"name":"Carey‐Ann D. Burnham","orcid":"0000-0002-1137-840X","position":1,"is_corresponding":false},{"id":709927,"name":"Maribeth R. Nicholson","orcid":"0000-0003-3941-5599","position":2,"is_corresponding":false},{"id":322994,"name":"Joseph P. Zackular","orcid":"0000-0002-3228-3055","position":3,"is_corresponding":false},{"id":388586,"name":"Larry K. Kociolek","orcid":"0000-0002-8756-3417","position":0,"is_corresponding":true}],"reference_count":4,"raw_metadata":null,"created_at":"2026-07-18T23:52:05.171356Z","pmid":"34791394","pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}