Clostridium difficile infection epidemiology and demographics

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Yazan Daaboul, M.D.

Overview

The incidence of C. difficile infection is estimated to be 140 per 100,000 individuals. In USA, the majority (65%) of cases are associated with healthcare settings, and 25% of cases are associated with previous hospitalizations. Although patients of all age groups may develop C. difficile infection, elderly patients > 65 years may have up to eight-fold increased risk of developing C. difficile infection compared with younger patients. Whites and female patients are more predisposed to develop C. difficile infections. Although C. difficile is abundantly reported in Europe and the United States, the infection is a global burden.

Epidemiology and Demographics

Incidence

  • The incidence of C. difficile infection is estimated to be 140 per 100,000 individuals and approximately 1,500 per 100,000 hospital discharges.[1]

In the U.S. Veterans Affairs system, approximately 0.5% of admissions have c diff[2][3].

Age

  • Patients of all age groups may develop C. difficile infection.
  • Elderly patients > 65 years may have up to eight-fold increased risk of developing C. difficile infection compared with younger patients.[1]

Gender

  • There is a slight female predisposition to the development of C. difficile infection with a female to male ratio of 1.26.[1]

Race

  • Caucasian individuals are more likely to develop C. difficile infection.[1]

Developed Countries

  • The estimated number of incident C. difficile infection in USA is estimated to be approximately range between approximately 397,000 and 508,500.[1]
  • In USA, the majority (65%) of cases are associated with healthcare settings, and 25% of cases are associated with previous hospitalizations.[1]
  • In USA, the NAP1 C. difficile strain is more common in healthcare settings than in community settings.
  • In 2011, approximately 29,000 deaths have been attributed to C. difficile infection in USA.[1]
  • Several C. difficile outbreaks have been reported in Canada, USA, and Europe.

Developing Countries

  • Although C. difficile is abundantly reported in Europe and the United States, the infection is a global burden.
  • The burden of C. difficile in developing countries is difficult to estimate due to scarcity of available data.

References

  1. 1.0 1.1 1.2 1.3 1.4 1.5 1.6 Lessa FC, Mu Y, Bamberg WM, Beldavs ZG, Dumyati GK, Dunn JR; et al. (2015). "Burden of Clostridium difficile infection in the United States". N Engl J Med. 372 (9): 825–34. doi:10.1056/NEJMoa1408913. PMID 25714160.
  2. Evans ME, Kralovic SM, Simbartl LA, Jain R, Roselle GA (2016). "Effect of a Clostridium difficile Infection Prevention Initiative in Veterans Affairs Acute Care Facilities". Infect Control Hosp Epidemiol. 37 (6): 720–2. doi:10.1017/ice.2016.27. PMID 26864803.
  3. Sumon ZE, Lesse AJ, Sellick JA, Tetewsky S, Mergenhagen KA (2020). "Temporal trends of inpatient C. difficile infections within the Veterans Health Administration hospitals: An analysis of the effect of molecular testing, time to testing, and mandatory reporting". Infect Control Hosp Epidemiol. 41 (1): 44–51. doi:10.1017/ice.2019.281. PMID 31708000.