title: Racial and ethnic disparities in health care-associated Clostridium difficile infections in the United States: State of the science.
abstract: BACKGROUND
  Among health care-associated infections (HAIs), Clostridium difficile infections (CDIs) are a major cause of morbidity and mortality in the United States. As national progress toward CDI prevention continues, it will be critical to ensure that the benefits from CDI prevention are realized across different patient demographic groups, including any targeted interventions.
  
  
  METHODS
  Through a comprehensive review of existing evidence for racial/ethnic and other disparities in CDIs, we identified a few general trends, but the results were heterogeneous and highlight significant gaps in the literature.
  
  
  RESULTS
  The majority of analyzed studies identified white patients as at increased risk of CDIs, although there is a very limited literature base, and many studies had significant methodological limitations.
  
  
  CONCLUSIONS
  Key recommendations for future research are provided to address antimicrobial stewardship programs and populations that may be at increased risk for CDIs.
authors.affiliation: Office of Disease Prevention and Health Promotion, US Department of Health and Human Services, Rockville, MD. Electronic address: sandra.yang@hhs.gov.
authors.forename: Sandra
authors.initials: S
authors.lastname: Yang
authors.affiliation: Office of Disease Prevention and Health Promotion, US Department of Health and Human Services, Rockville, MD.
authors.forename: Briana B
authors.initials: BB
authors.lastname: Rider
authors.affiliation: Office of Disease Prevention and Health Promotion, US Department of Health and Human Services, Rockville, MD; Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA.
authors.forename: Avi
authors.initials: A
authors.lastname: Baehr
authors.affiliation: Office of Disease Prevention and Health Promotion, US Department of Health and Human Services, Rockville, MD.
authors.forename: Aaron R
authors.initials: AR
authors.lastname: Ducoffe
authors.affiliation: Office of Disease Prevention and Health Promotion, US Department of Health and Human Services, Rockville, MD.
authors.forename: Dale J
authors.initials: DJ
authors.lastname: Hu
mesh_terms: D016360:Clostridioides difficile / Q000302:isolation & purification*; D003015:Clostridium Infections / Q000453:epidemiology / Q000208:ethnology* / Q000517:prevention & control; D003428:Cross Infection / Q000453:epidemiology / Q000208:ethnology* / Q000517:prevention & control; D005006:Ethnicity; D005260:Female; D054625:Healthcare Disparities; D006801:Humans; D008297:Male; D061214:Patient Safety; D044469:Racial Groups; D012306:Risk; D014481:United States / Q000453:epidemiology
keywords: Clostridium difficile; Ethnicity; Health care disparity; Health care–associated infection; Patient safety; Race