Community- and Healthcare-Associated Clostridium difficile Infections, Finland, 2008−2013

• Main Authors: Saara M. Kotila, Silja Mentula, Jukka Ollgren, Anni Virolainen-Julkunen, Outi Lyytikäinen
• Format: Article
• Language: English
• Published: Centers for Disease Control and Prevention 2016-10-01
• Series: Emerging Infectious Diseases
• Subjects: Clostridium difficile; bacteria; community-associated infections; healthcare-associated infections; CDIs; incidence
• Online Access: https://wwwnc.cdc.gov/eid/article/22/10/15-1492_article
• ISSN: 1080-6040; 1080-6059

We evaluated incidence, case-fatality rate, and trends of community-associated (CA) and healthcare-associated (HA) Clostridium difficile infections (CDIs) in Finland during 2008–2013. CDIs were identified in the National Infectious Disease Register, deaths in the National Population Information System, hospitalizations to classify infections as CA or HA in the National Hospital Discharge Register, and genotypes in a reference laboratory. A total of 32,991 CDIs were identified: 10,643 (32.3%) were CA (32.9 cases/100,000 population) and 22,348 (67.7%) HA (69.1/100,000). Overall annual incidence decreased from 118.7/100,000 in 2008 to 92.1/100,000 in 2013, which was caused by reduction in HA-CDI rates (average annual decrease 8.1%; p<0.001). The 30-day case-fatality rate was lower for CA-CDIs than for HA-CDIs (3.2% vs. 13.3%; p<0.001). PCR ribotypes 027 and 001 were more common in HA-CDIs than in CA-CDIs. Although the HA-CDI incidence rate decreased, which was probably caused by increased awareness and improved infection control, the CA-CDI rate increased.