Clostridium Difficile-Associated Disease in U.S. Hospitals, 1993-2005. Statistical Brief No. 50

摘要

Healthcare-associated infections (HAIs) are an important public health problem in the U.S. One type of infection that is primarily regarded as an HAI, is Clostridium difficile-associated disease (CDAD). CDAD describes a broad spectrum of patient illness, ranging from uncomplicated diarrhea in its mildest form, to fulminant sepsis, resulting in colectomy and even death, in its most severe manifestations. CDAD is recognized as an important cause of diarrhea in healthcare facilities where it has been associated with excess lengths of stay and substantial increases in healthcare costs. Transmission to patients occurs primarily via the hands of healthcare personnel or from a contaminated environment. Previous antimicrobial therapy is a well-established risk factor for CDAD and is thought to suppress the normal flora of the colon, allowing growth of Clostridium difficile after exposure occurs. Recent evidence suggests that the epidemiology of CDAD may be changing, resulting in increases in both disease incidence and severity. This Statistical Brief presents data from the Healthcare Cost and Utilization Project (HCUP) on the trend in CDAD from 1993 to 2005 and provides details on CDAD hospitalizations for 2005. A recent evaluation of surveillance for CDAD in hospitals found high sensitivity (78%) and specificity (99.7%) when using International Classification of Diseases, 9th Revision (ICD-9) codes. Although it is not possible to determine whether these infections originated in a healthcare setting or were community acquired, this report provides information on the national burden of CDAD in hospitalized patients, and describes the types of patients affected, and their associated outcomes in the hospital. All differences between estimates noted in the text are statistically significant at the 0.05 level or better.