Clostridium difficile infection incidence and mortality in Alberta

Abstract

Clostridium difficile infection (CDI) is the leading cause of hospital-acquired diarrhea. It causes significant morbidity and mortality, manifesting in life threatening conditions such as pseudomembranous colitis. This study determined the incidence of CDI in Alberta, investigated risk factors associated with mortality amongst Alberta CDI patients, and investigated the inter-rater reliability between the Death Attribution Rules for Patients Infected by C. difficile (DARPIC) algorithm and IPC physicians. Incidence of CDI in Alberta hospitals, continuing care facilities, and the community provided a comprehensive understanding of CDI in Alberta. Although CDI is predominantly a nosocomial infection, 47% of the CDI cases identified in this study occurred in the community. Risk factors for mortality amongst hospitalized CDI patients were increasing age and comorbidity count, liver disease, and metastatic solid tumour. Attributing death to CDI is difficult and opinions vary by clinicians, to accurately and consistently report attributable CDI mortality a standardized approach is necessary.