Published April 15, 2020 INFECTIOUS DISEASE Healthcare-Associated C Difficile Infections Show Substantial Decline By staff Atlanta, GA—With the current laser focus on the war against COVID-19, victory in another medical battle might have been overlooked.A report in the New England Journal of Medicine describes substantial progress in the fight to prevent Clostridioides difficile infection in hospitals.The Emergency Infections Program, led by researchers from the CDC, Emory University School of Medicine, and the Veterans Affairs Medical Center, notes that efforts to combat C difficile continue, but whether those initiatives are resulting in a reduction in cases had remained unclear.To remedy that, the study team identified cases of C difficile infection—using stool specimens positive for C difficile in anyone older than age 1year with no positive test in the previous 8 weeks—at 10 sites in the U.S.Case and census sampling weights were used to estimate the national burden of C difficile infection, first recurrences, hospitalizations, and in-hospital deaths from 2011 through 2017. For the study, healthcare-associated infections were defined as those with onset in a healthcare facility or associated with recent admission to a healthcare facility, with all others classified as community-associated infections. Results indicate that the number of cases of C difficile infection in the 10 U.S. sites was 15,461 in 2011—10,177 healthcare-associated and 5,284 community-associated cases—versus 15,512 in 2017—7,973 healthcare-associated and 7,539 community-associated cases. At the same time, the estimated national burden of C difficile infection was 476,400 cases (95% CI, 419,900-532,900) in 2011 and 462,100 cases (95% CI, 428,600-495,600) in 2017. Researchers point out that “the adjusted estimate of the total burden of C difficile infection decreased by 24% (95% CI, 6-36) from 2011 through 2017; the adjusted estimate of the national burden of healthcare-associated C difficile infection decreased by 36% (95% CI, 24-54), whereas the adjusted estimate of the national burden of community-associated C difficile infection was unchanged. The adjusted estimate of the burden of hospitalizations for C difficile infection decreased by 24% (95% CI, 0-48), whereas the adjusted estimates of the burden of first recurrences and in-hospital deaths did not change significantly.”The report concludes that the estimated national burden of C difficile infection and associated hospitalizations decreased from 2011 through 2017, largely because of a decline in healthcare-associated infections. “Enhanced prevention strategies that target healthcare- and community-associated [C. difficile infection] may further reduce the overall infection rate. Improving outpatient antibiotic use can also help reduce antibiotic-associated adverse events like CDI and improve patient safety,” the CDC notes. « Click here to return to Weekly News Update.