Maternal transmission during labor of symptomatic Clostridioides difficile infection to two premature neonates

Clostridioides difficile infections (CDI) in neonates are challenging to diagnose due to high asymptomatic gut colonization rates with C. difficile in newborns and the difficulty of differentiating colonization and infection with laboratory tests. Here, we describe a case of a severe CDI with a complicated course in a 48-year old mother who had prior hospitalization and antibiotic treatment. She gave birth to a triplet at 31 weeks AD and transmitted C. difficile PCR ribotype 002 onto two of the newborns. The infected neonates subsequently developed diarrhea which responded well to anti-CDI treatment. Conclusion: Consider testing for CDI in neonates if the mother has CDI during the peripartum period.