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

Comments

Originally published as: 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. Original publication available here

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

Creative Commons Attribution 4.0 License
This work is licensed under a Creative Commons Attribution 4.0 License.

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