e-journal

Determinants of Clostridium difficile Infection Incidence Across Diverse United States Geographic Locations

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Background. Clostridium difficile infection (CDI) is no longer restricted to hospital settings, and populationbased incidence measures are needed. Understanding the determinants of CDI incidence will allow for more meaningful comparisons of rates and accurate national estimates.

Methods. Data from active population- and laboratory-based CDI surveillance in 7 US states were used to identify CDI cases (ie, residents with positive C difficile stool specimen without a positive test in the prior 8 weeks). Cases were classified as community-associated (CA) if stool was collected as outpatients or ≤3 days of admission and no overnight healthcare facility stay in the past 12 weeks; otherwise, cases were classified as healthcare-associated (HA). Two regression models, one for CA-CDI and another for HA-CDI, were built to evaluate predictors of high CDI incidence. Site-specific incidence was adjusted based on the regression models.

Results. Of 10 062 cases identified, 32% were CA. Crude incidence varied by geographic area; CA-CDI ranged
from 28.2 to 79.1/100 000 and HA-CDI ranged from 45.7 to 155.9/100 000. Independent predictors of higher CACDI incidence were older age, white race, female gender, and nucleic acid amplification test (NAAT) use. For HACDI, older age and a greater number of inpatient-days were predictors. After adjusting for relevant predictors, the range of incidence narrowed greatly; CA-CDI rates ranged from 30.7 to 41.3/100 000 and HA-CDI rates ranged from 58.5 to 94.8/100 000.

Conclusions. Differences in CDI incidence across geographic areas can be partially explained by differences in NAAT use, age, race, sex, and inpatient-days. Variation in antimicrobial use may contribute to the remaining differences in incidence.

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Informasi Detail

Judul Seri

Open Forum Infectious Diseases

No. Panggil

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Penerbit

Oxford : Oxford University Press on behalf of the Infectious Diseases Society of America., 2014

Deskripsi Fisik

Open Forum Infectious Diseases, Volume 1 Issue 2 Summer 2014

Bahasa

English

ISBN/ISSN

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Klasifikasi

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Tipe Isi

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Tipe Media

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Tipe Pembawa

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Edisi

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Subjek

KESEHATAN

Info Detail Spesifik

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Pernyataan Tanggungjawab

agus

Versi lain/terkait

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