Trends in U.S. Burden of Clostridioides difficile Infection and Outcomes

著者: Alice Guh, Yi Mu, Lisa G. Winston, Helen Johnston, Danyel Olson, Monica M. Farley, Lucy Wilson, Stacy Holzbauer, Erin C. Phipps, Ghinwa Dumyati, Zintars G. Beldavs, Marion Kainer, Maria Karlsson, Dale N. Gerding, L. Clifford McDonald - New England Journal of Medicine, NEJM 2020 被引用: 840

BACKGROUND: infection is unclear. METHODS: infection, first recurrences, hospitalizations, and in-hospital deaths from 2011 through 2017. Health care-associated infections were defined as those with onset in a health care facility or associated with recent admission to a health care facility; all others were classified as community-associated infections. For trend analyses, we used weighted random-intercept models with negative binomial distribution and logistic-regression models to adjust for the higher sensitivity of nucleic acid amplification tests (NAATs) as compared with other test types. RESULTS: infection decreased by 24% (95% CI, 0 to 48), whereas the adjusted estimates of the burden of first recurrences and in-hospital deaths did not change significantly. CONCLUSIONS: infection and associated hospitalizations decreased from 2011 through 2017, owing to a decline in health care-associated infections. (Funded by the Centers for Disease Control and Prevention.).