Molecular Epidemiology and Genetic Relatedness of Clostridioides difficile Isolates in Pediatric Oncology and Transplant Patients using Whole Genome Sequencing

Whole genome sequencing (WGS) identified a highly diverse group of C. difficile isolates among pediatric oncology and transplant patients (POTP) with CDI. Although WGS identified clusters of closely related isolates in multiple patients, epidemiologic investigation of shared inpatient exposures identified potential transmission in only four clusters.C. difficile transmission was uncommon. Recurrent and incident CDI are often misclassified by clinical surveillance criteria.