Clostridium difficile Infection in the Department of Defense (DOD): 2007-2013
Technical rept. 1 Jan 2007-31 Dec 2013
NAVY AND MARINE CORPS PUBLIC HEALTH CENTER PORTSMOUTH VA EPIDATA CENTER DEPT
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Reports of increased incidence and severity have renewed interest in the epidemiology of Clostridium difficile infection CDI. This retrospective report summarizes trends for CDI for Department of Defense DOD and Department of the Navy DON beneficiaries from 2007-2013. CDI trends among both populations were similar and CDI incidence rates increased approximately 9.5 among all beneficiaries. Most notably, the increase occurred among beneficiaries with community-acquired CA CDI. For most DOD and DON beneficiaries, trends indicate that the vast majority of CDI were both acquired and identified in the community setting. The traditional risk factors antibiotic use, ages 65 years and older and hospitalization continue to be important to consider in the diagnostic evaluation of CDI. However, among all beneficiaries, the majority of CDI episodes were acquired in the community in ages ranging from 45 years and older. In addition, although most cases had an antibiotic prescribed in the 90 days before symptom onset, approximately 30 of beneficiaries did not have a history of antibiotic use. Therefore, providers should suspect CDI in any patient with acute inflammatory diarrhea including patients with no antibiotic use or healthcare facility exposures.
- Medicine and Medical Research