Patient characteristics, clinical results and severe outcomes of 17 202 adults diagnosed with health care–associated Clostridium difficile infection from 2009 to 2015*
| Variable | 2009 | 2010 | 2011 | 2012 | 2013 | 2014 | 2015 | 2009–2015 |
|---|---|---|---|---|---|---|---|---|
| Year-round surveillance | ||||||||
| No. of hospitals | 42 | 44 | 46 | 45 | 45 | 51 | 53 | – |
| No. of patients† | 1627 | 2307 | 2795 | 2645 | 2746 | 2593 | 2489 | 17 202 |
| Sex, female, no. (%) | 766 (48.0) | 1178 (51.3) | 1456 (52.3) | 1275 (48.4) | 1350 (49.2) | 1270 (49.0) | 1216 (48.9) | 8511 (49.7) |
| Age, yr, mean ± SD | 69.6 ± 16.2 | 70.4 ± 16.4 | 69.4 ± 17.1 | 69.7 ± 16.6 | 68.9 ± 17.0 | 68.2 ± 17.1 | 68.1 ± 16.8 | 69.2 ± 16.8 |
| Age group, yr, no. (%) | ||||||||
| 18–64 | 534 (32.8) | 723 (31.4) | 961 (34.4) | 851 (34.5) | 947 (34.5) | 939 (36.2) | 923 (37.1) | 5878 (34.2) |
| ≥ 65 | 1092 (67.2) | 1580 (68.6) | 1830 (65.6) | 1793 (67.8) | 1796 (65.5) | 1654 (63.8) | 1566 (62.9) | 11 311 (65.8) |
| Time to C. difficile test from the date of admission, d, median (IQR) | 13 (6–30) | 13 (6–27) | 12 (6–27) | 12 (6–26) | 12 (7–25) | 12 (7–25) | 10 (5–21) | 12 (6–26) |
| Patients diagnosed with health care–associated C. difficile infection on readmission, no. (%) | 170 (10.4) | 296 (12.8) | 336 (12.0) | 301 (11.4) | 405 (14.7) | 333 (12.8) | 421 (16.9) | 2262 (13.1) |
| March and April targeted surveillance | ||||||||
| No. of cases | 559 | 478 | 564 | 532 | 543 | 531 | 477 | 3684 |
| Clinical results | ||||||||
| Temperature, °C, mean ± SD | 37.1 ± 0.8 | 37.1 ± 0.8 | 37.1 ± 0.8 | 37.2 ± 0.8 | 37.0 ± 0.7 | 37.2 ± 0.8 | 37.2 ± 0.7 | 37.1 ± 0.8 |
| Leukocyte count, ×109/L, median (IQR) | 13.0 (8.3–18.4) | 11.3 (8.0–16.2) | 11.1 (7.0–16.6) | 11.2 (7.7–16.5) | 10.9 (7.0–16.5) | 11.3 (7.4–16.8) | 12.3 (7.7–17.7) | 11.5 (7.7–16.9) |
| Albumin, g/L, median (IQR) | 26.0 (21.0–30.0) | 27.0 (22.0–31.0) | 27.0 (22.0–32.0) | 26.0 (22.0–31.0) | 25.0 (21.0–29.0) | 26.0 (21.0–30.5) | 25.0 (21.0–31.0) | 27.0 (23.1–31.0) |
| Severe outcomes within 30 d, no. (%) | ||||||||
| ICU admission | ||||||||
| All-cause | 4 (7.7) | 27 (5.8) | 35 (6.4) | 30 (5.7) | 46 (8.5) | 30 (5.7) | 41 (9.8) | 251 (7.0) |
| Complication from C. difficile infection | 12 (2.2) | 14 (3.0) | 10 (1.8) | 3 (0.6) | 9 (1.7) | 12 (2.3) | 11 (2.6) | 71 (2.0) |
| Colectomy | 9 (1.6) | 9 (2.4) | 6 (1.1) | 9 (1.7) | 5 (0.9) | 8 (1.6) | 5 (1.3) | 51 (1.3) |
| Patient status‡ | ||||||||
| Discharged or transferred | 317 (57.1) | 255 (55.1) | 306 (55.0) | 308 (58.7) | 326 (60.4) | 305 (59.6) | 269 (64.8) | 2086 (58.5) |
| Remained in hospital | 157 (28.3) | 148 (32.0) | 167 (30.0) | 149 (28.4) | 149 (27.6) | 144 (28.1) | 88 (21.2) | 1002 (281) |
| Death (all cause) | 81 (14.6) | 60 (13.0) | 84 (15.1) | 68 (13.0) | 65 (12.0) | 63 (12.3) | 58 (14.0) | 479 (13.4) |
| Death attributable to C. difficile infection | 13 (2.3) | 26 (5.6) | 36 (6.5) | 24 (4.6) | 21 (3.9) | 22 (4.3) | 16 (3.9) | 158 (4.4) |
Note: ICU = intensive care unit, IQR = interquartile range, SD = standard deviation.
↵* Not all subgroup values total the population size because of missing data. Percentages are calculated on the basis of available data.
↵† Excluding adult patients missing standardized data form received and pediatric patients.
↵‡ Excluding unknown.