Trends in Incidence and Clinical Outcomes of Clostridioides difficile Infection, Hong Kong

• Published in: Emerging infectious diseases Vol. 27; no. 12; pp. 3036 - 3044
• Main Authors: Guo, Cosmos L T, Kwong, Thomas N Y, Mak, Joyce W Y, Zhang, Lin, Lui, Grace C Y, Wong, Grace L H, Ip, Margaret, Yu, Jun, Sung, Joseph J Y, Wu, William K K, Wong, Sunny H
• Format: Journal Article
• Language: English
• Published: United States U.S. National Center for Infectious Diseases 01.12.2021; Centers for Disease Control and Prevention
• Subjects: Age; Antibiotics; antimicrobial resistance; Clinical outcomes; Clostridioides difficile; Clostridium infections; Clostridium Infections - diagnosis; Clostridium Infections - epidemiology; Disease; Drug use; Epidemics; Epidemiology; Health facilities; Hong Kong; Hong Kong - epidemiology; Hospital patients; Hospitalization; Humans; Incidence; Infection, Hong Kong; Laboratories; Mortality; Patient outcomes; Patients; pseudomembranous colitis; Regression analysis; Risk factors; Statistics; surveillance; Trends in Incidence and Clinical Outcomes of; Hong Kong; Hong Kong China; United States > US; Asia; Europe; China; Hong Kong; bacteria; Hong Kong. Emerg Infect Dis. 2021 Dec [date cited]. https://doi.org/10.3201/eid2712.203769; Kwong TNY; pseudomembranous colitis; Lui GCY; Zhang L; et al. Trends in incidence and clinical outcomes of Clostridioides difficile infection; epidemiology; antimicrobial resistance; Clostridioides difficile; Mak JWY; surveillance; Suggested citation for this article: Guo CLT; Wong GLH
• ISSN: 1080-6040; 1080-6059
• DOI: 10.3201/eid2712.203769

We conducted a territorywide survey to investigate the epidemiology, risk factors, and clinical outcomes of Clostridioides difficile infection (CDI) among hospitalized patients in Hong Kong. A total of 17,105 cases of CDI were identified, of which 15,717 (91.9%) were healthcare-associated and 1,025 (6.0%) were community-associated. Although CDI incidence increased substantially from 2006 to 2017, it plateaued in 2018 and 2019. The 30-day mortality rates decreased from 20.1% in 2015 to 16.8% in 2019, whereas the 60-day recurrence rates remained constant at ≈11% during the study period. Cross-correlation statistic showed significant correlations between incidence trend and overall antimicrobial drug use (r = 0.865, p<0.001), which has decreased as a result of an antibiotic stewardship program initiated in 2017. Our data suggest a turning point in C. difficile epidemiology that could be related to the changing pattern of antimicrobial drug use.