Mariam Younas1,2, Julie Royer3, Sharon B Weissman4,5, Katie S Waites6, Sangita Dash4,5, Hana Rac7,8, P Brandon Bookstaver7,8, Julie Ann Justo7,8, Linda Bell6, Anton Maki6, Majdi N Al-Hasan9,10. 1. University of South Carolina School of Medicine, Columbia, SC, USA. drmariamyounas@gmail.com. 2. Department of Medicine, Palmetto Health University of South Carolina Medical Group, Columbia, SC, USA. drmariamyounas@gmail.com. 3. Health and Demographics Division, South Carolina Revenue and Fiscal Affairs Office, Columbia, SC, USA. 4. University of South Carolina School of Medicine, Columbia, SC, USA. 5. Department of Medicine, Palmetto Health University of South Carolina Medical Group, Columbia, SC, USA. 6. South Carolina Department of Health and Environmental Control, Columbia, SC, USA. 7. Department of Clinical Pharmacy and Outcomes Sciences, University of South Carolina College of Pharmacy, Columbia, SC, USA. 8. Department of Pharmacy, Prisma Health Richland, Columbia, SC, USA. 9. University of South Carolina School of Medicine, Columbia, SC, USA. majdi.alhasan@uscmed.sc.edu. 10. Department of Medicine, Palmetto Health University of South Carolina Medical Group, Columbia, SC, USA. majdi.alhasan@uscmed.sc.edu.
Abstract
OBJECTIVES: This cross-sectional population-based study aims to determine overall incidence rate of Clostridioides difficile infection (CDI) in the State of South Carolina and provide an estimated cost of hospitalization due to community-associated CDI (CA-CDI). METHODS: All CDI cases in South Carolina were identified through National Healthcare Safety Network (NHSN) and the South Carolina Infectious Disease and Outbreak Network (SCION) from January 1, 2015 to June 30, 2016, excluding infants < 1 year of age. RESULTS: During the 18-month study period, 10,254 CDI events were identified in South Carolina residents with an overall incidence rate of 139/100,000 person-years. Over one-half of CDI cases were CA-CDI (5192; 51%) with an incidence rate of 71/100,000 person-years. Among patients with CA-CDI, 2127 (41%) required hospitalization with a median length of stay of 5 days. The annual burden of CA-CDI in South Carolina was estimated to be 9282 hospital days and $16,217,295 in hospitalization costs. CONCLUSION: The incidence rate of CA-CDI in South Carolina has surpassed both community-onset healthcare facility associated and hospital-onset CDI combined. The heavy burden of CA-CDI justifies dedication of public health resources to combat CDI in ambulatory settings, through antimicrobial stewardship initiatives.
OBJECTIVES: This cross-sectional population-based study aims to determine overall incidence rate of Clostridioides difficile infection (CDI) in the State of South Carolina and provide an estimated cost of hospitalization due to community-associated CDI (CA-CDI). METHODS: All CDI cases in South Carolina were identified through National Healthcare Safety Network (NHSN) and the South Carolina Infectious Disease and Outbreak Network (SCION) from January 1, 2015 to June 30, 2016, excluding infants < 1 year of age. RESULTS: During the 18-month study period, 10,254 CDI events were identified in South Carolina residents with an overall incidence rate of 139/100,000 person-years. Over one-half of CDI cases were CA-CDI (5192; 51%) with an incidence rate of 71/100,000 person-years. Among patients with CA-CDI, 2127 (41%) required hospitalization with a median length of stay of 5 days. The annual burden of CA-CDI in South Carolina was estimated to be 9282 hospital days and $16,217,295 in hospitalization costs. CONCLUSION: The incidence rate of CA-CDI in South Carolina has surpassed both community-onset healthcare facility associated and hospital-onset CDI combined. The heavy burden of CA-CDI justifies dedication of public health resources to combat CDI in ambulatory settings, through antimicrobial stewardship initiatives.