title: A population-based longitudinal study of Clostridium difficile infection-related hospitalization in mid-age and older Australians.
abstract: Clostridium difficile is the principal cause of infectious diarrhoea in hospitalized patients. We investigated the incidence and risk factors for hospitalization due to C. difficile infection (CDI) in older Australians. We linked data from a population-based prospective cohort study (the 45 and Up Study) of 266 922 adults aged ⩾45 years recruited in New South Wales, Australia to hospitalization and death records for 2006-2012. We estimated the incidence of CDI hospitalization and calculated days in hospital and costs per hospitalization. We also estimated hazard ratios (HR) for CDI hospitalization using Cox regression with age as the underlying time variable. Over a total follow-up of 1 126 708 person-years, 187 adults had an incident CDI hospitalization. The crude incidence of CDI hospitalization was 16·6/100 000 person-years, with a median hospital stay of 6 days, and a median cost of AUD 6102 per admission. Incidence increased with age and year of follow-up, with a threefold increase for 2009-2012. After adjustment, CDI hospitalization rates were significantly lower in males than females (adjusted HR 0·6, 95% confidence interval 0·4-0·7). CDI hospitalization rates increased significantly over 2009-2012. There is a need to better understand the increasing risk of CDI hospitalization in women.
authors: Research School of Population Health,Australian National University,Canberra,Australia.
authors: Y
authors: Y
authors: Chen
authors: Research School of Population Health,Australian National University,Canberra,Australia.
authors: K
authors: K
authors: Glass
authors: School of Public Health and Community Medicine,University of New South Wales,Sydney,Australia.
authors: B
authors: B
authors: Liu
authors: Microbiology & Immunology, University of Western Australia, and Department of Microbiology Path West Laboratory Medicine,Queen Elizabeth II Medical Centre,Nedlands,Australia.
authors: T V
authors: TV
authors: Riley
authors: Research School of Population Health,Australian National University,Canberra,Australia.
authors: R
authors: R
authors: Korda
authors: Research School of Population Health,Australian National University,Canberra,Australia.
authors: M D
authors: MD
authors: Kirk
mesh_terms: D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D016360:Clostridioides difficile / Q000302:isolation & purification*; D003015:Clostridium Infections / Q000453:epidemiology* / Q000382:microbiology; D003967:Diarrhea / Q000453:epidemiology* / Q000382:microbiology; D005260:Female; D017048:Health Care Costs; D006760:Hospitalization; D006801:Humans; D015994:Incidence; D007902:Length of Stay; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D009517:New South Wales / Q000453:epidemiology; D011446:Prospective Studies; D012307:Risk Factors; D012737:Sex Factors
keywords: 
                 Clostridium difficile
              ; epidemiology