Viprey, VF orcid.org/0000-0001-6463-7092, Davis, GL, Benson, AD et al. (11 more authors) (2022) A point-prevalence study on community and inpatient Clostridioides difficile infections (CDI): results from Combatting Bacterial Resistance in Europe CDI (COMBACTE-CDI), July to November 2018. Eurosurveillance, 27 (26). ISSN 1560-7917
Abstract
Background
There is a paucity of data on community-based Clostridioides difficile infection (CDI) and how these compare with inpatient CDI.
Aim
To compare data on the populations with CDI in hospitals vs the community across 12 European countries.
Methods
For this point-prevalence study (July–November 2018), testing sites sent residual diagnostic material on sampling days to a coordinating laboratory for CDI testing and PCR ribotyping (n = 3,163). Information on whether CDI testing was requested at the original site was used to identify undiagnosed CDI. We used medical records to identify differences between healthcare settings in patient demographics and risk factors for detection of C. difficile with or without free toxin.
Results
The CDI positivity rate was 4.4% (country range: 0–16.2) in hospital samples, and 1.3% (country range: 0–2.2%) in community samples. The highest prevalence of toxinotype IIIb (027, 181 and 176) was seen in eastern European countries (56%; 43/77), the region with the lowest testing rate (58%; 164/281). Different predisposing risk factors were observed (use of broad-spectrum penicillins in the community (OR: 8.09 (1.9–35.6), p = 0.01); fluoroquinolones/cephalosporins in hospitals (OR: 2.2 (1.2–4.3), p = 0.01; OR: 2.0 (1.1–3.7), p = 0.02)). Half of community CDI cases were undetected because of absence of clinical suspicion, accounting for three times more undiagnosed adults in the community compared with hospitals (ca 111,000 vs 37,000 cases/year in Europe).
Conclusion
These findings support recommendations for improving diagnosis in patients presenting with diarrhoea in the community, to guide good practice to limit the spread of CDI.
Metadata
Item Type: | Article |
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Authors/Creators: |
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Copyright, Publisher and Additional Information: | This article is copyright of the authors or their affiliated institutions, 2022. This work is licensed under a Creative Commons Attribution 4.0 International License. |
Keywords: | Clostridioides difficile; community; diagnosis; hospital |
Dates: |
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Institution: | The University of Leeds |
Academic Units: | The University of Leeds > Faculty of Medicine and Health (Leeds) > School of Dentistry (Leeds) > Oral Biology (Leeds) |
Depositing User: | Symplectic Publications |
Date Deposited: | 08 Jul 2022 15:45 |
Last Modified: | 08 Jul 2022 15:45 |
Status: | Published |
Publisher: | European Centre for Disease Prevention and Control |
Identification Number: | 10.2807/1560-7917.es.2022.27.26.2100704 |
Related URLs: | |
Open Archives Initiative ID (OAI ID): | oai:eprints.whiterose.ac.uk:188700 |