C. diff Infections Increasingly Community-Acquired

By Kelly Young

Edited by Susan Sadoughi, MD, and Richard Saitz, MD, MPH, FACP, DFASAM

An increasing proportion of Clostridioides difficile infection (CDI) cases treated by hospitals are community-acquired, finds a large study in JAMA Network Open.

Researchers examined more than 2 million admissions into 43 Southern hospitals between 2013 and 2017. Of these, 21,000 were diagnosed with CDI.

During that time, the median total CDI incidence rose from 7.9 to 9.3 cases per 1000 admissions. Community-acquired CDI incidence increased from 3.7 to 5.6 cases per 1000, while healthcare facility-associated CDI held relatively steady, around 8.5 cases per 10,000 patient-days. The proportion of CDI cases that were community-acquired rose from 49% to 61%.

The authors write: "The reasons for the higher proportion of CDI cases in the community remain unclear but could signal the existence of independent reservoirs of CDI in the community."