Volume 23, Number 10—October 2017
Research
Disease Burden of Clostridium difficile Infections in Adults, Hong Kong, China, 2006–2014
Jeffery Ho1, Rudin Z.W. Dai1, Thomas N.Y. Kwong, Xiansong Wang, Lin Zhang, Margaret Ip, Raphael Chan, Peter M.K. Hawkey, Kelvin L.Y. Lam, Martin C.S. Wong, Gary Tse, Matthew T.V. Chan, Francis K.L. Chan, Jun Yu, Siew C. Ng, Nelson Lee, Justin C.Y. Wu, Joseph J.Y. Sung, William K.K. Wu
, and Sunny H. Wong
, and Sunny H. Wong
Table 2
Characteristics of patients with Clostridium difficile infections, Hong Kong, China, 2006–2014*
| Characteristic | No. (%) patients |
||
|---|---|---|---|
| Overall, n = 15,753† | HA-CDI, n = 14,402 | CA-CDI, n = 817 | |
| Age, y | |||
| <44 | 1,040 (6.6) | 893 (6.2) | 105 (12.9) |
| 45–64 | 2,930 (18.6) | 2,621 (18.2) | 203 (24.8) |
| 65–84 | 7,026 (44.6) | 6,495 (45.1) | 301 (36.9) |
| >85 | 4,757 (30.2) | 4,393 (30.5) | 208 (25.4) |
| Sex | |||
| M | 7,624 (48.4) | 7,028 (48.8) | 337 (41.2) |
| F | 8,129 (51.6) | 7,374 (51.2) | 480 (58.8) |
| Resident of home for elderly persons | 4,757 (30.2) | 4,393 (30.5) | 203 (24.9) |
| Severe disease | 6,868 (43.6) | 6,294 (43.7) | 340 (41.6) |
| Antimicrobial drug use‡ | |||
| High-risk drug | 10,397 (66.0) | 9,822 (68.2) | 299 (36.6) |
| Medium-risk drug | 11,909 (75.6) | 11,320 (78.6) | 318 (38.9) |
| Low-risk drug | 221 (1.4) | 216 (1.5) | 74 (1.4) |
| Diagnostic test | |||
| Bacterial culture | 4,883 (31.0) | 4,421 (30.7) | 259 (31.7) |
| Toxin detection | 5,246 (33.3) | 4,940 (34.3) | 195 (23.9) |
| NAAT | 5,624 (35.7) | 5,041 (35.0) | 363 (44.4) |
| Use of proton-pump inhibitor | 7,530 (47.8) | 7,086 (49.2) | 180 (22.0) |
| Use of histamine-2 receptor antagonist | 7,451 (47.3) | 6,927 (48.1) | 273 (33.4) |
| Concurrent condition | |||
| Myocardial infarction | 1,497 (9.5) | 1,411 (9.8) | 29 (3.6) |
| Cerebrovascular disease | 5,183 (32.9) | 4,825 (33.5) | 176 (21.6) |
| Chronic lung disease | 2,410 (15.3) | 2,232 (15.5) | 100 (12.2) |
| Diabetes mellitus | 2,899 (18.4) | 2,693 (18.7) | 103 (12.6) |
| Renal disease | 3,592 (22.8) | 3,341 (23.2) | 113 (13.8) |
| Nonmetastatic tumor | 3,970 (25.2) | 3,701 (25.7) | 134 (16.4) |
| AIDS | 79 (0.5) | 58 (0.4) | 13 (1.6) |
| Inflammatory bowel disease | 95 (0.6) | 58 (0.4) | 36 (4.4) |
| Deaths | |||
| During hospital stay | 3,733 (23.7) | 3,528 (24.5) | 51 (6.2) |
| 30-d all-cause | 3,544 (22.5) | 3,341 (23.2) | 80 (9.8) |
| 60-d all-cause | 5,088 (32.3) | 4,781 (33.2) | 106 (13.0) |
| Recurrence, d§ | |||
| 30 | 961 (6.1) | 907 (6.3) | 17 (2.1) |
| 60 | 1,229 (7.8) | 1,152 (8.0) | 25 (3.0) |
| 90 | 1,339(8.5) | 1,267 (8.8) | 28 (3.4) |
| 180 | 1,481(9.4) | 1,397 (9.7) | 33 (4.0) |
*CA-CDI, community-associated C. difficile infection; CDI; HA-CDI, healthcare-associated C. difficile infection; NAAT, nucleic acid amplification test.
†Sum of HA-CDI and CA-CDI cases might not equal number of overall CDI cases because of missing information in the registry.
‡Antimicrobial drug use 8 weeks before diagnosis was stratified into high risk (floroquinolones, cephalosporins, and clindamycin); medium risk (penicillins, macrolides, and sulfonamides); and low risk (tetracyclines).
§Defined as reappearance of symptoms after initial resolution and a positive CDI test result.
1These authors contributed equally to this article.
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