Clostridium difficile infection in a French university hospital: Eight years of prospective surveillance study.
The epidemiology of Clostridium difficile infection (CDI) has changed with an increase in incidence and severity. Prospective surveillance was therefore implemented in a French university hospital to monitor the characteristics of patients at risk and to recognize local trends. Between 2007 and 2014, all hospitalized patients (≥18 years) with CDI were included. During the survey, the mean incidence rate of CDI was 2.9 per 10,000 hospital-days. In all, 590 patients were included. Most of the episodes were healthcare-associated (76.1%). The remaining cases were community-acquired (18.1%) and unknown (5.9%). The comparison with healthcare-associated cases showed that the community-acquired group had a lower rate of antimicrobial exposure (P < 0.001), proton pump inhibitor (P < 0.001), and immunosuppressive drugs (P = 0.02). Over the study period, death occurred in 61 patients (10.3%), with 18 (29.5%) being related to CDI according to the physician in charge of the patient. Active surveillance of CDI is required to obtain an accurate picture of the real dimensions of CDI.
University of Lyon 1, University of Lyon Infection Control Unit, Edouard Herriot hospital, Hospices Civils de Lyon Laboratory of microbiology, Groupement Hospitalier Est, Hospices Civils de Lyon, Bron Laboratoire des Pathogènes Emergents-Fondation Mérieux, Centre International de Recherche en Infectiologie, INSERM U1111, CNRS UMR5308, ENS de LYON, UCBL1, Lyon, France.
Nagham
N
Khanafer
Luc
L
Oltra
Monique
M
Hulin
Olivier
O
Dauwalder
Francois
F
Vandenesch
Philippe
P
Vanhems
D000368:Aged; D016360:Clostridioides difficile / Q000302:isolation & purification*; D003015:Clostridium Infections / Q000453:epidemiology* / Q000382:microbiology; D003428:Cross Infection / Q000453:epidemiology* / Q000382:microbiology; D005260:Female; D005500:Follow-Up Studies; D005602:France / Q000453:epidemiology; D006785:Hospitals, University / Q000706:statistics & numerical data*; D006801:Humans; D015994:Incidence; D008297:Male; D011159:Population Surveillance; D011446:Prospective Studies; D012307:Risk Factors; D013997:Time Factors