Burden of Clostridium difficile Infection in the United States

By Fernanda C. Lessa, Yi Mu, Wendy M. Bamberg, Z. Beldavs, G. Dumyati, John R. Dunn, M. Farley, S. Holzbauer, James I. Meek, Erin C. Phipps and 7 more. New England Journal of Medicine, 2015

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background The magnitude and scope of Clostridium difficile infection in the United States continue to evolve. methods In 2011, we performed active population- and laboratory-based surveillance across 10 geographic areas in the United States to identify cases of C. difficile infection (stool specimens positive for C. difficile on either toxin or molecular assay in residents ≥1 year of age). Cases were classified as community-associated or health care–associated. In a sample of cases of C. difficile infection, specimens were cultured and isolates underwent molecular typing. We used regression models to calculate estimates of national incidence and total number of infections, first recurrences, and deaths within 30 days after the diagnosis of C. difficile infection. results A total of 15,461 cases of C. difficile infection were identified in the 10 geographic areas; 65.8% were health care–associated, but only 24.2% had onset during hospitalization. After adjustment for predictors of disease incidence, the estimated number of incident C. difficile infections in the United States was 453,000 (95% confidence interval [CI], 397,100 to 508,500). The incidence was estimated to be higher among females (rate ratio, 1.26; 95% CI, 1.25 to 1.27), whites (rate ratio, 1.72; 95% CI, 1.56 to 2.0), and persons 65 years of age or older (rate ratio, 8.65; 95% CI, 8.16 to 9.31). The estimated number of first recurrences of C. difficile infection was 83,000 (95% CI, 57,000 to 108,900), and the estimated number of deaths was 29,300 (95% CI, 16,500 to 42,100). The North American pulsed-field gel electrophoresis type 1 (NAP1) strain was more prevalent among health care–associated infections than among community-associated infections (30.7% vs. 18.8%, P<0.001) conclusions C. difficile was responsible for almost half a million infections and was associated with approximately 29,000 deaths in 2011. (Funded by the Centers for Disease Control and Prevention.)

Subfields: Infectious Diseases

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Citations in the corpus

Consequences of bile salt biotransformations by intestinal bacteria (2016, background): “million infections and 29,000 deaths in the US per year.(116) Moreover, as the world population ages, a higher percentage of the elderly are colonized by C.”
Clinical Practice Guidelines for Clostridium difficile Infection in Adults and Children: 2017 Update by the Infectious Diseases Society of America (IDSA) and Society for Healthcare Epidemiology of America (SHEA). (2018, positive): “Recent estimates suggest the US burden of CDI is close to 500 000 infections annually, although the exact magnitude of burden is highly dependent upon the type of diagnostic tests used [6].”
A Generalizable, Data-Driven Approach to Predict Daily Risk of Clostridium difficile Infection at Two Large Academic Health Centers (2018, background): “Infect Control Hosp Epidemiol 2018;39:425–433 An estimated 293,300 healthcare-associated cases of Clostridium difficile infection (CDI) occur annually in the United States.1 Earlier identification of patients at high risk for CDI can allow for earlier treatment with improved outcomes2,3 as well as i”