Changing Epidemiology of Clostridium Difficile and CDI
- Increased incidence and severity of CDI is resulting in increased length of hospitalization, more frequent discharge to long term care facilities among people previously residing at home, and increased healthcare costs.
- These increases are associated with the detection of a new epidemic strain- BI/NAP1/027, toxinotrype III. This strain, historically uncommon, is now epidemic throughout the United States. Features of this strain include:
- Increased resistance to fluoroquinolones
- Presence of an extra toxin (binary toxin)
- Polymorphism in toxins A and B regulatory gene (tcdC) and increased toxin production in vitro
- CDI has recently been identified among previously low-risk populations (e.g. peripartum women, generally healthy community members those without recent antibiotic history)
- During 2009 and 2010, greater than 50% of CDI cases among rural populations in specific Minnesota counties had illness onset in the community rather than in a hospital or long term care setting.
Updated Tuesday, 10-Jan-2012 12:22:33 CST