Community-onset (CO) accounts for a significant proportion of Clostridium difficile infections (CDI) in the Veterans Health Administration (VHA) system and is more common than hospital-onset CDI, a recent study found. The retrospective cohort study included all patients with a positive test for C. difficile within VHA Corporate Data Warehouse (CDW) between January 1, 2011 and December 31, 2014. Researchers found:
- 19,270 episodes of CDI were identified, involving 15,972 unique patients (95% male, 44% had a HCF onset, 42% were CO).
- 31% of cases were non-severe, 40% were severe, and 21% were fulminant.
- Overall, 40% of patients received antibiotics in the 90 days before CDI (44% in HCF vs 36% in CO).
- Recurrence was noted for 18.2% of all cases; 30-day all-cause mortality was 9.2%.
Pinzon MCM, Buie R, Liou J, et al. Outcomes of community and healthcare onset Clostridium difficile infection. [Published online ahead of print August 23, 2018]. Clin Infect Dis. doi:10.1093/cid/ciy715.
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Antibiotic Use and Hospital Onset CDI Infection, Clin Infect Dis; ePub 2019 Mar 1; Kazakova, et al
Decolonization Lowers Postdischarge Infection Risk, N Engl J Med; 2019 Feb 14; Huang, et al
30-Day Readmission After S. aureus Bacteremia, Clin Infect Dis; ePub 2019 Feb 11; Inagaki, et al
Bloodstream Infections in Hospitalized Children, Clin Infect Dis; ePub 2018 Dec 9; Spaulding, et al