review · Infectious Disease Reports
Clostridioides difficile infection remains a major driver of healthcare-associated illness worldwide. An analysis pooling data from 59 studies across 24 countries published between 2016 and 2024 highlights significant variations in disease impact across clinical settings, regions, and patient groups. Incidence was notably elevated in hospital-onset healthcare environments, reaching 5.31 cases per 1,000 admissions, whilst long-term care facilities recorded 44.24 cases per 10,000 patient-days. Paediatric groups experienced higher infection rates than adults, with 4.52 cases per 1,000 admissions compared to 2.13 for adults. Community-acquired cases had the highest recurrence rate at 16.22 percent. Mortality was recorded at 8.32 percent within 30 days and 16.05 percent when duration was unspecified. Overall burden was concentrated in healthcare settings, long-term care institutions, paediatric cohorts, and North America, indicating clear priorities for infection control.
Clostridioides difficile causes severe bowel infections and substantial mortality, particularly in medical environments. Quantifying where the risk is highest helps healthcare providers, public health bodies, and care homes allocate resources effectively. By identifying vulnerable groups such as children and long-term care residents, institutions can introduce targeted infection control measures and antimicrobial stewardship programmes to reduce transmission and prevent recurrent illness.
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Background: Clostridioides difficile infection (CDI) is a major cause of healthcare-associated infections globally. Understanding variations in CDI incidence and outcomes across settings, populations, and regions is important for guiding prevention strategies. Aim: The aim of this study was to determine the global epidemiology of CDI to better understand disease burden across settings and geographic regions. Methods: Relevant publications were identified through searches of major databases, including PubMed, Scopus, and Web of Science, published from 1 January 2016 through 24 July 2024. Random effects models were used to pool estimates, and 95% confidence intervals (CIs) were calculated. Results: A total of 59 studies, representing 24 countries across North America, Europe, the Asia–Pacific region, Latin America, and the Middle East, met the inclusion criteria. The incidence of CDI was highest in hospital-onset healthcare facility settings, with 5.31 cases/1000 admissions (95% CI 3.76–7.12) and 5.00 cases/10,000 patient-days (95% CI 3.96–6.15). Long-term care facilities reported 44.24 cases/10,000 patient-days (95% CI 39.57–49.17). Pediatric populations faced a greater risk, with 4.52 cases/1000 admissions (95% CI 0.55–12.17), than adults did at 2.13 (95% CI 1.69–2.61). Recurrence rates were highest for community-acquired CDI at 16.22%. The death rates for the CDI cases tracked for 30 days and of unspecified duration were 8.32% and 16.05%, respectively. Conclusions: This comprehensive review identified healthcare facilities, long-term care, pediatric populations, and North America as disproportionately burdened. This finding provides guidance on priority areas and populations for targeted prevention through antimicrobial stewardship, infection control, and surveillance.
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DOI: 10.3390/idr17020031
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