Trends in U.S. Burden of Clostridioides difficile Infection and Outcomes

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dc.contributor.authorGuh, Alice Y.
dc.contributor.authorMu, Yi
dc.contributor.authorWinston, Lisa G.
dc.contributor.authorJohnston, Helen
dc.contributor.authorOlson, Danyel
dc.contributor.authorFarley, Monica M.
dc.contributor.authorWilson, Lucy E.
dc.contributor.authorHolzbauer, Stacy M.
dc.contributor.authorPhipps, Erin C.
dc.contributor.authorDumyati, Ghinwa K.
dc.contributor.authorBeldavs, Zintars G.
dc.contributor.authorKainer, Marion A.
dc.contributor.authorKarlsson, Maria
dc.contributor.authorGerding, Dale N.
dc.contributor.authorMcDonald, L. Clifford
dc.contributor.authorEmerging Infections Program Clostridioides difficile Infection Working Group
dc.date.accessioned2022-06-03T14:58:26Z
dc.date.available2022-06-03T14:58:26Z
dc.date.issued2020-04-02
dc.descriptionEmerging Infections Program Clostridioides difficile Infection Working Group: Lauren Korhonen, Brittany Martin, Geoffrey Brousseau, Wendy Bamberg, Elizabeth Basiliere, James Meek, Rebecca Perlmutter, Maria Bye, Tory Whitten, Emily B. Hancock, Rebecca Tsay, Deborah Nelson, Trupti Hatwar, Valerie L.S. Ocampo, Miranda D. Smith, Ashley Paulick, Michelle Adamczyken_US
dc.description.abstractBACKGROUND Efforts to prevent Clostridioides difficile infection continue to expand across the health care spectrum in the United States. Whether these efforts are reducing the national burden of C. difficile infection is unclear. METHODS The Emerging Infections Program identified cases of C. difficile infection (stool specimens positive for C. difficile in a person ≥1 year of age with no positive test in the previous 8 weeks) in 10 U.S. sites. We used case and census sampling weights to estimate the national burden of C. difficile infection, first recurrences, hospitalizations, and in-hospital deaths from 2011 through 2017. Health care–associated infections were defined as those with onset in a health care facility or associated with recent admission to a health care facility; all others were classified as community-associated infections. For trend analyses, we used weighted random-intercept models with negative binomial distribution and logistic-regression models to adjust for the higher sensitivity of nucleic acid amplification tests (NAATs) as compared with other test types. RESULTS The number of cases of C. difficile infection in the 10 U.S. sites was 15,461 in 2011 (10,177 health care–associated and 5284 community-associated cases) and 15,512 in 2017 (7973 health care–associated and 7539 community-associated cases). The estimated national burden of C. difficile infection was 476,400 cases (95% confidence interval [CI], 419,900 to 532,900) in 2011 and 462,100 cases (95% CI, 428,600 to 495,600) in 2017. With accounting for NAAT use, the adjusted estimate of the total burden of C. difficile infection decreased by 24% (95% CI, 6 to 36) from 2011 through 2017; the adjusted estimate of the national burden of health care–associated C. difficile infection decreased by 36% (95% CI, 24 to 54), whereas the adjusted estimate of the national burden of community-associated C. difficile infection was unchanged. The adjusted estimate of the burden of hospitalizations for C. difficile infection decreased by 24% (95% CI, 0 to 48), whereas the adjusted estimates of the burden of first recurrences and in-hospital deaths did not change significantly. CONCLUSIONS The estimated national burden of C. difficile infection and associated hospitalizations decreased from 2011 through 2017, owing to a decline in health care–associated infections. (Funded by the Centers for Disease Control and Prevention.)en_US
dc.description.urihttps://www.nejm.org/doi/full/10.1056/NEJMoa1910215en_US
dc.format.extent11 pagesen_US
dc.genrejournal articlesen_US
dc.identifierdoi:10.13016/m2ljs6-d6df
dc.identifier.citationGuh, Alice Y. Trends in U.S. Burden of Clostridioides difficile Infection and Outcomes. New England Journal of Medcine no. 382 (Apr. 2, 2020) , pp 1320-1330. https://www.nejm.org/doi/full/10.1056/NEJMoa1910215en_US
dc.identifier.uri10.1056/NEJMoa1910215
dc.identifier.urihttp://hdl.handle.net/11603/24815
dc.language.isoen_USen_US
dc.publisherMassachusetts Medical Societyen_US
dc.relation.isAvailableAtThe University of Maryland, Baltimore County (UMBC)
dc.relation.ispartofUMBC Emergency Health Services Department Collection
dc.relation.ispartofUMBC Faculty Collection
dc.rightsThis work was written as part of one of the author's official duties as an Employee of the United States Government and is therefore a work of the United States Government. In accordance with 17 U.S.C. 105, no copyright protection is available for such works under U.S. Law.en_US
dc.rightsPublic Domain Mark 1.0*
dc.rights.urihttp://creativecommons.org/publicdomain/mark/1.0/*
dc.titleTrends in U.S. Burden of Clostridioides difficile Infection and Outcomesen_US
dc.typeTexten_US

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