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The rise in Clostridium difficile infection incidence among hospitalized adults in the United States: 2001-2010

  • Kelly R. Reveles
    Correspondence
    Address correspondence to Kelly R. Reveles, PharmD, PhD, Pharmacotherapy Education and Research Center, The University of Texas Health Science Center at San Antonio, 7703 Floyd Curl Dr, MSC-6220, San Antonio, TX 78229-3900.
    Affiliations
    College of Pharmacy, The University of Texas at Austin, Austin, TX

    Pharmacotherapy Education and Research Center, The University of Texas Health Science Center at San Antonio, San Antonio, TX
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  • Grace C. Lee
    Affiliations
    College of Pharmacy, The University of Texas at Austin, Austin, TX

    Pharmacotherapy Education and Research Center, The University of Texas Health Science Center at San Antonio, San Antonio, TX
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  • Natalie K. Boyd
    Affiliations
    College of Pharmacy, The University of Texas at Austin, Austin, TX

    Pharmacotherapy Education and Research Center, The University of Texas Health Science Center at San Antonio, San Antonio, TX
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  • Christopher R. Frei
    Affiliations
    College of Pharmacy, The University of Texas at Austin, Austin, TX

    Pharmacotherapy Education and Research Center, The University of Texas Health Science Center at San Antonio, San Antonio, TX
    Search for articles by this author

      Background

      Clostridium difficile infection (CDI) incidence is a growing concern. This study provides national estimates of CDI over 10 years and identifies trends in mortality and hospital length of stay (LOS) among hospitalized adults with CDI.

      Methods

      We conducted a retrospective analysis of the US National Hospital Discharge Surveys from 2001-2010. Eligible cases included adults aged ≥18 years discharged from a hospital with an ICD-9-CM diagnosis code for CDI (008.45). Data weights were used to derive national estimates. CDI incidence rates were depicted as CDI discharges per 1,000 total adult discharges.

      Results

      These data represent 2.2 million adult hospital discharges for CDI over the study period. CDI incidence increased from 4.5 CDI discharges per 1,000 total adult discharges in 2001 to 8.2 CDI discharges per 1,000 total adult discharges in 2010. The overall in-hospital mortality rate was 7.1% for the study period. Mortality increased slightly over the study period, from 6.6% in 2001 to 7.2% in 2010. Median hospital LOS was 8 days (interquartile range, 4-14 days), and remained stable over the study period.

      Conclusions

      The incidence of CDI among hospitalized adults in the United States nearly doubled from 2001-2010. Furthermore, there is little evidence of improvement in patient mortality or hospital LOS.

      Key Words

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