Increasing Incidence of Multiply Recurrent <i>Clostridium difficile</i> Infection
Authors: Mark Wilcox
Journal: Annals of Internal Medicine (2018)

Letters20 February 2018Increasing Incidence of Multiply Recurrent Clostridium difficile InfectionMark Wilcox, MDMark Wilcox, MDLeeds Teaching Hospital, Leeds, United Kingdom (M.W.)Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/L17-0600 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail TO THE EDITOR:Ma and colleagues (1) describe an apparent increase in the incidence of multiply recurrent Clostridium difficile infection (mrCDI). The potential for confounding is considerable because of changes in methods of diagnosing C difficile infection (CDI). Diagnosis was based on coding with (sometimes assumed) receipt of antibiotics. During the study period (2001 through 2012), a pronounced change took place in U.S. laboratory diagnostic methods for CDI. Diagnosis by nucleic acid amplification testing (NAAT) was not practiced early in this period, but 52% of laboratories in a major U.S. national surveillance study were doing so by 2011 (2).Nucleic ...References1. Ma GK, Brensinger CM, Wu Q, Lewis JD. Increasing incidence of multiply recurrent Clostridium difficile infection in the United States: a cohort study. Ann Intern Med. 2017;167:152-8. [PMID: 28672282]. doi:10.7326/M16-2733 LinkGoogle Scholar2. Lessa FC, Mu Y, Bamberg WM, Beldavs ZG, Dumyati GK, Dunn JR, et al. Burden of Clostridium difficile infection in the United States. N Engl J Med. 2015;372:825-34. [PMID: 25714160] doi:10.1056/NEJMoa1408913 CrossrefMedlineGoogle Scholar3. Planche TD, Davies KA, Coen PG, Finney JM, Monahan IM, Morris KA, et al. Differences in outcome according to Clostridium difficile testing method: a prospective multicentre diagnostic validation study of C difficile infection. Lancet Infect Dis. 2013;13:936-45. [PMID: 24007915] doi:10.1016/S1473-3099(13)70200-7 CrossrefMedlineGoogle Scholar4. Marra AR, Edmond MB, Ford BA, Herwaldt LA, Algwizani AR, Diekema DJ. Failure of risk-adjustment by test method for C. difficile laboratory-identified event reporting. Infect Control Hosp Epidemiol. 2017;38:109-11. [PMID: 27745553] doi:10.1017/ice.2016.227 CrossrefMedlineGoogle Scholar5. Mawer D, Byrne F, Drake S, Brown C, Warne B, Bousfield R, et al. Hospital-onset diarrhoea prevalence, aetiology and management in the United Kingdom: the HOODINI study [Abstract]. Presented at European Congress of Clinical Microbiology and Infectious Diseases, Vienna, Austria, 22–25 April 2017. Abstract no. OS0230. Google Scholar Author, Article, and Disclosure InformationAffiliations: Leeds Teaching Hospital, Leeds, United Kingdom (M.W.)Disclosures: Disclosures can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=L17-0600. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoIncreasing Incidence of Multiply Recurrent Clostridium difficile Infection in the United States Gene K. Ma , Colleen M. Brensinger , Qufei Wu , and James D. Lewis Increasing Incidence of Multiply Recurrent Clostridium difficile Infection Jodie A. Barkin , Neil Stollman , and Jamie S. Barkin Increasing Incidence of Multiply Recurrent Clostridium difficile Infection Gene K. Ma and James D. Lewis Metrics 20 February 2018Volume 168, Issue 4Page: 307KeywordsAntibioticsClostridium infectionsDatabasesDiarrheaDisclosureHealth careNucleic acidsPatientsResearch laboratoriesSpecificity ePublished: 20 February 2018 Issue Published: 20 February 2018 Copyright & PermissionsCopyright © 2018 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...