Document Type
Journal Article
Publication Title
Epidemiology and Infection
ISSN
1469-4409
Volume
147
First Page
153
Last Page
153
PubMed ID
31063109
Publisher
Cambridge University Press
School
School of Medical and Health Sciences
RAS ID
28386
Abstract
Clostridium difficile, the most common cause of hospital-associated diarrhoea in developed countries, presents major public health challenges. The high clinical and economic burden from C. difficile infection (CDI) relates to the high frequency of recurrent infections caused by either the same or different strains of C. difficile. An interval of 8 weeks after index infection is commonly used to classify recurrent CDI episodes. We assessed strains of C. difficile in a sample of patients with recurrent CDI in Western Australia from October 2011 to July 2017. The performance of different intervals between initial and subsequent episodes of CDI was investigated. Of 4612 patients with CDI, 1471 (32%) were identified with recurrence. PCR ribotyping data were available for initial and recurrent episodes for 551 patients. Relapse (recurrence with same ribotype (RT) as index episode) was found in 350 (64%) patients and reinfection (recurrence with new RT) in 201 (36%) patients. Our analysis indicates that 8- and 20-week intervals failed to adequately distinguish reinfection from relapse. In addition, living in a non-metropolitan area modified the effect of age on the risk of relapse. Where molecular epidemiological data are not available, we suggest that applying an 8-week interval to define recurrent CDI requires more consideration.
DOI
10.1017/S0950268819000499
Creative Commons License
This work is licensed under a Creative Commons Attribution 4.0 License.
Comments
Alfayyadh, M., Collins, D. A., Tempone, S., McCann, R., Armstrong, P. K., Riley, T. V., & Cook, A. (2019). Recurrence of Clostridium difficile infection in the Western Australian population. Epidemiology and Infection, 147, Article e153. Available here