University of South Carolina School of Medicine, Columbia, SC, USA.
Department of Medicine, Palmetto Health University of South Carolina Medical Group, Columbia, SC, USA.
Infection. 2020 Feb;48(1):129-132. doi: 10.1007/s15010-019-01368-5. Epub 2019 Nov 1.
This cross-sectional population-based study aims to determine overall incidence rate of Clostridioides difficile infection (CDI) in the State of South Carolina and provide an estimated cost of hospitalization due to community-associated CDI (CA-CDI).
All CDI cases in South Carolina were identified through National Healthcare Safety Network (NHSN) and the South Carolina Infectious Disease and Outbreak Network (SCION) from January 1, 2015 to June 30, 2016, excluding infants < 1 year of age.
During the 18-month study period, 10,254 CDI events were identified in South Carolina residents with an overall incidence rate of 139/100,000 person-years. Over one-half of CDI cases were CA-CDI (5192; 51%) with an incidence rate of 71/100,000 person-years. Among patients with CA-CDI, 2127 (41%) required hospitalization with a median length of stay of 5 days. The annual burden of CA-CDI in South Carolina was estimated to be 9282 hospital days and $16,217,295 in hospitalization costs.
The incidence rate of CA-CDI in South Carolina has surpassed both community-onset healthcare facility associated and hospital-onset CDI combined. The heavy burden of CA-CDI justifies dedication of public health resources to combat CDI in ambulatory settings, through antimicrobial stewardship initiatives.
本横断面基于人群的研究旨在确定南卡罗来纳州艰难梭菌感染（CDI）的总发病率，并估计因社区相关 CDI（CA-CDI）而住院的费用。
通过国家医疗保健安全网络（NHSN）和南卡罗来纳传染病和暴发网络（SCION），从 2015 年 1 月 1 日至 2016 年 6 月 30 日，确定南卡罗来纳州的所有 CDI 病例，但不包括<1 岁的婴儿。
在 18 个月的研究期间，南卡罗来纳州居民中发现了 10254 例 CDI 事件，总发病率为 139/100000 人年。超过一半的 CDI 病例为 CA-CDI（5192；51%），发病率为 71/100000 人年。在 CA-CDI 患者中，有 2127 人（41%）需要住院治疗，中位住院时间为 5 天。南卡罗来纳州 CA-CDI 的年负担估计为 9282 个住院日和 16217295 美元的住院费用。
南卡罗来纳州 CA-CDI 的发病率已超过社区获得性医疗机构相关和医院获得性 CDI 的总和。CA-CDI 的沉重负担证明了在非住院环境中投入公共卫生资源通过抗菌药物管理计划来对抗 CDI 的合理性。
