title: Epidemiology and Risk Factors for Community-Associated Clostridium difficile Infection: A Narrative Review.
abstract: Clostridium difficile infection (CDI) was once considered a primarily nosocomial concern. Emerging evidence from the last 20 years has highlighted a drastic shift in the known epidemiology of CDI, with disease outside of hospitals apparently occurring more frequently and causing severe disease in populations that were thought to be at low risk. This narrative review summarises potential pathways for infection outside of the hospital environment and highlights likely routes of transmission. Further, evidence is presented on potential risk factors for development of disease. Understanding the epidemiology of CDI outside of hospitals is essential to the ability to prevent and control disease in vulnerable populations.
authors.affiliation: School of Health Sciences, Flinders University, Bedford Park, SA, Australia.|Western Australian Department of Health, Communicable Diseases Control Directorate, Shenton Park, WA, Australia.
authors.forename: Lauren E
authors.initials: LE
authors.lastname: Bloomfield
authors.affiliation: Department of Microbiology, PathWest Laboratory Medicine, Queen Elizabeth II Medical Centre, Nedlands, WA, Australia. thomas.riley@uwa.edu.au.|School of Medical and Health Sciences, Edith Cowan University, Joondalup Drive, Joondalup, 6027, WA, Australia. thomas.riley@uwa.edu.au.|School of Veterinary and Life Sciences, Murdoch University, South Street, Murdoch, 6150, WA, Australia. thomas.riley@uwa.edu.au.
authors.forename: Thomas V
authors.initials: TV
authors.lastname: Riley
keywords: Animal reservoir/source; Clostridium difficile infection (CDI); Community-associated CDI; Epidemiology; Risk factors