Community- and Healthcare-AssociatedClostridium difficileInfections, Finland, 2008−20131

Abstract

Prudent use of antimicrobial drugs in outpatient settings is needed for reducing the burden of infection.

Disease Burden ofClostridium difficileInfections in Adults, Hong Kong, China, 2006–2014

“…Clostridium difficile infection (CDI) is a major cause of nosocomial illness worldwide. CDI is associated with high rates of mortality and illness ( 1 ) and has a case-fatality rate of up to 14% within 30 days after diagnosis ( 2 ). Disease recurrence further increases illness rates, reduces quality of life, and might occur in up to 27% of the incident cases ( 3 ).…”

“…The disease burden of CDI has been well studied in Europe and North America. Although antimicrobial drug stewardship programs have contributed to a decrease in incidence in some countries, such as the United Kingdom and Finland ( 2 , 4 ), CDI is still a major health burden in other countries. In South Korea, a nationwide study showed an increasing trend in incidence of CDI ( 5 ).…”

“…A major proportion of CDI cases was attributable to a community in the United States ( 1 ). In Finland, episodes of CA-CDI have shown a major increase versus an overall decrease in disease incidence ( 2 ). Surveillance of CDI cases diagnosed during admission of patients showed that up to 50% of CDI cases were community associated ( 3 , 7 ).…”

Clostridioides difficile: diagnosis and treatments

“…C difficile infection is no longer restricted to hospital settings, and is increasingly prevalent in the community. Currently, more than a quarter of all cases of C difficile infection are estimated to be community acquired,293031 although community acquired infection is still under-recognized because of a lack of screening by community physicians 3233. Epidemiological studies have shown that community associated C difficile infection affects groups not previously at risk (younger patients and those with no exposure to antibiotics in the 12 weeks before infection) 29.…”

Status of vaccine research and development for Clostridium difficile

“…These include RTs 056, 078 and 126 that are commonly associated with infections in farm animals [47]. Changes in clinically relevant types may additionally reflect the significant rise in CAI, which comprises more than 40% of all cases in some studies [48]. Interestingly, within individual countries, particular types appear to dominate, for example 017 isolates account for 20% of Shanghai isolates whilst in Stockholm, 005 strains are prevalent [49]; in Scotland 078 isolates account for over 10% of infections [50].…”