Population-Based Surveillance of <i>Clostridium difficile</i> Infection in Manitoba, Canada, by Using Interim Surveillance Definitions

Lambert, Pascal; Dyck, Myrna; Thompson, Laura H.; Hammond, Greg

doi:10.1086/605719

Cited by 65 publications

(42 citation statements)

References 14 publications

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“…However, a recent active case-finding study for CA-CDI conducted in the United Kingdom ( 20 ) suggested rates of 20–30 per 100,000, similar to the studies conducted in Sweden ( 8 , 18 ). Furthermore, a recent study from Manitoba, Canada, found that ≈20% of CDI cases were CA, and annual incidence was ≈20/100,000 ( 21 ). Apparent differences in the incidence of CA-CDI likely reflect differences both in study approaches and population characteristics.…”

Section: Discussionmentioning

confidence: 99%

Risk Factors for and Estimated Incidence of Community-associatedClostridium difficileInfection, North Carolina, USA¹

Kutty

Woods

Seña

et al. 2010

Emerg. Infect. Dis.

195

104

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Section: Discussionmentioning

confidence: 99%

Risk Factors for and Estimated Incidence of Community-associatedClostridium difficileInfection, North Carolina, USA¹

Kutty

Woods

Seña

et al. 2010

Emerg. Infect. Dis.

195

104

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“…Although C. difficile is the number one cause of hospital-acquired diarrhea, it is not exclusively a nosocomial pathogen (34,192). Numbers of cases of community-acquired and community-associated infection are increasing worldwide; around the world, up to 25% of cases are community acquired, and these patients may not have the traditional risk factors for CDI, such as advanced age, antibiotic exposure, and medications to suppress gastric acid (188,(192)(193)(194)(195). A pilot study was recently conducted whereby whole-genome sequencing (this method is discussed in more detail below) was performed in almost real time to evaluate C. difficile transmission.…”

Section: Evolving Epidemiology Clinical Implications Of Strain Typingmentioning

confidence: 99%

Diagnosis of Clostridium difficile Infection: an Ongoing Conundrum for Clinicians and for Clinical Laboratories

2013

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SUMMARY Clostridium difficile is a formidable nosocomial and community-acquired pathogen, causing clinical presentations ranging from asymptomatic colonization to self-limiting diarrhea to toxic megacolon and fulminant colitis. Since the early 2000s, the incidence of C. difficile disease has increased dramatically, and this is thought to be due to the emergence of new strain types. For many years, the mainstay of C. difficile disease diagnosis was enzyme immunoassays for detection of the C. difficile toxin(s), although it is now generally accepted that these assays lack sensitivity. A number of molecular assays are commercially available for the detection of C. difficile . This review covers the history and biology of C. difficile and provides an in-depth discussion of the laboratory methods used for the diagnosis of C. difficile infection (CDI). In addition, strain typing methods for C. difficile and the evolving epidemiology of colonization and infection with this organism are discussed. Finally, considerations for diagnosing C. difficile disease in special patient populations, such as children, oncology patients, transplant patients, and patients with inflammatory bowel disease, are described. As detection of C. difficile in clinical specimens does not always equate with disease, the diagnosis of C. difficile infection continues to be a challenge for both laboratories and clinicians.

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“…Community-acquired CDI was likely previously underdiagnosed owing to a lack of awareness of CDI outside the hospital setting. Data from North America and Europe suggest that 20%–27% of all CDI cases are community-associated, with an incidence of 20–30 per 100,000 population 3,13,29,30. In a population-based US study, 41% of the 385 definite CDI cases were community-acquired; the overall incidence of community-acquired and hospital-acquired CDI increased by 5.3-fold and 19.3-fold, respectively, over the study period 12.…”

Section: Epidemiology Of Community-acquired CDImentioning

confidence: 99%

Community-acquired Clostridium difficile infection: an increasing public health threat

Gupta¹,

Khanna²

2014

IDR

112

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There has been a startling shift in the epidemiology of Clostridium difficile infection over the last decade worldwide, and it is now increasingly recognized as a cause of diarrhea in the community. Classically considered a hospital-acquired infection, it has now emerged in populations previously considered to be low-risk and lacking the traditional risk factors for C. difficile infection, such as increased age, hospitalization, and antibiotic exposure. Recent studies have demonstrated great genetic diversity for C. difficile, pointing toward diverse sources and a fluid genome. Environmental sources like food, water, and animals may play an important role in these infections, apart from the role symptomatic patients and asymptomatic carriers play in spore dispersal. Prospective strain typing using highly discriminatory techniques is a possible way to explore the suspected diverse sources of C. difficile infection in the community. Patients with community-acquired C. difficile infection do not necessarily have a good outcome and clinicians should be aware of factors that predict worse outcomes in order to prevent them. This article summarizes the emerging epidemiology, risk factors, and outcomes for community-acquired C. difficile infection.

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Population-Based Surveillance of Clostridium difficile Infection in Manitoba, Canada, by Using Interim Surveillance Definitions

Cited by 65 publications

References 14 publications

Risk Factors for and Estimated Incidence of Community-associatedClostridium difficileInfection, North Carolina, USA¹

Risk Factors for and Estimated Incidence of Community-associatedClostridium difficileInfection, North Carolina, USA¹

Diagnosis of Clostridium difficile Infection: an Ongoing Conundrum for Clinicians and for Clinical Laboratories

Community-acquired Clostridium difficile infection: an increasing public health threat

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Population-Based Surveillance of Clostridium difficile Infection in Manitoba, Canada, by Using Interim Surveillance Definitions

Cited by 65 publications

References 14 publications

Risk Factors for and Estimated Incidence of Community-associatedClostridium difficileInfection, North Carolina, USA1

Risk Factors for and Estimated Incidence of Community-associatedClostridium difficileInfection, North Carolina, USA1

Diagnosis of Clostridium difficile Infection: an Ongoing Conundrum for Clinicians and for Clinical Laboratories

Community-acquired Clostridium difficile infection: an increasing public health threat

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Risk Factors for and Estimated Incidence of Community-associatedClostridium difficileInfection, North Carolina, USA¹

Risk Factors for and Estimated Incidence of Community-associatedClostridium difficileInfection, North Carolina, USA¹