Journal Article

Characterization of Healthcare-Associated and Community-Associated Clostridioides difficile Infections among Adults, Canada, 2015–2019

Langley, Joanne M., Kibsey, Pamela, Han, Guanghong, Choi, Kelly B., Srigley, Jocelyn A., Evans, Gerald A., Silva, Anada, Pelude, Linda, Minion, Jessica, Stagg, Paula, Longtin, Yves, Hizon, Romeo, Golding, George R., Lee, Bonita E., Comeau, Jeannette L., Davis, Ian, Science, Michelle, Suh, Kathryn N., Wong, Alice, Frenette, Charles, Johnstone, Jennie, Thampi, Nisha, Al-Rawahi, Ghada N., Brooks, James, Katz, Kevin C., Du, Tim, Mertz, Dominik, Chow, Blanda, Hota, Susy S., Collet, Jun C.

2022

Overview

We investigated epidemiologic and molecular characteristics of healthcare-associated (HA) and community-associated (CA) Clostridioides difficile infection (CDI) among adult patients in Canadian Nosocomial Infection Surveillance Program hospitals during 2015-2019. The study encompassed 18,455 CDI cases, 13,735 (74.4%) HA and 4,720 (25.6%) CA. During 2015-2019, HA CDI rates decreased by 23.8%, whereas CA decreased by 18.8%. HA CDI was significantly associated with increased 30-day all-cause mortality as compared with CA CDI (p<0.01). Of 2,506 isolates analyzed, the most common ribotypes (RTs) were RT027, RT106, RT014, and RT020. RT027 was more often associated with CDI-attributable death than was non-RT027, regardless of acquisition type. Overall resistance C. difficile rates were similar for all drugs tested except moxifloxacin. Adult HA and CA CDI rates have declined, coinciding with changes in prevalence of RT027 and RT106. Infection prevention and control and continued national surveillance are integral to clarifying CDI epidemiology, investigation, and control.

• Publisher: U.S. National Center for Infectious Diseases,Centers for Disease Control and Prevention
• Subject: Adult / Antibiotics / Antimicrobial agents / antimicrobial resistance / bacteria / C. difficle / Canada - epidemiology / Characterization of Healthcare-Associated and Community-Associated / Clostridioides difficile - genetics / Clostridioides difficile infection / Clostridium infections / Clostridium Infections - drug therapy / Clostridium Infections - epidemiology / Community-acquired infections / community-associated infections / Cross infection / Cross Infection - epidemiology / Delivery of Health Care / Drug resistance / Epidemiology / Health care / healthcare-associated infections / Humans / Infections among Adults, Canada, 2015–2019 / Laboratories / Microbial Sensitivity Tests / Mortality / Nosocomial infection / Nosocomial infections / Patient outcomes / Patients / Ribotyping / Risk factors / Statistics / Surveillance / Trends