Global burden and prevalence trends of CDI

Could you estimate the global burden of Clostridium difficile infection (CDI) and describe the prevalence trends of this infection in the recent decades?

Christine Lee: With regard to the global burden of CDI, it is not quite known because it is not always reportable. But we do know that in North America over half a million individuals are affected by the infection each year. Combining that with the European countries, it is likely 1 million individuals each year.

With regard to the health-care–associated infections of CDI, it used to be approximately 85 per 100,000 patient-days in 1995, but over the next 2 decades it has actually declined in terms of health-care–associated CDI to approximately 50 per 100,000 patient-days.

What we are seeing is more of community-associated CDI. Some may argue that although we would label it as community-associated, there may be a link to health care. But we are seeing individuals who have not been to any health-care facilities and who have not even received antibiotics coming in with CDI.