Changing Epidemiology of C. difficile and CDI - Minnesota Dept. of Health

Changing Epidemiology of Clostridium difficile and CDI

  • Increased incidence and severity of CDI is resulting in:
    • Increased length of hospitalization
    • More people being discharged to long-term care facilities who previously resided at home
    • Increased health care costs
  • These increases are associated with the detection of a new epidemic strain: B1/NAP1/027, toxinotype III.
    • This strain, historically uncommon, is now epidemic throughout the United States.
    • Features of this new strain include:
      • Increased resistance to fluoroquinolones (a type of antibiotic)
      • Presence of an extra toxin (binary toxin)
      • Increased production of toxins A and B
  • Since 2005, CDI has been identified among previously low-risk populations (e.g. generally healthy community members and those without recent antibiotic history).
    • An estimated 50-65% of CDI is community associated.
      • In Minnesota, in 2017 63% and 2016 58% were CA-CDI.
    • Contact with children less than 2 years of age has been associated with community-associated CDI.
  • CDI remains a mostly health care associated disease.
    Although community-associated patients have not been hospitalized, a majority have had other recent health care exposures (such as dental office visits, outpatient clinics visits, and in outpatient surgical centers).

Updated Tuesday, 28-May-2019 08:41:48 CDT