Volume 31, Number 6—June 2025
Research
Characterization of Adult and Pediatric Healthcare-Associated and Community-Associated Clostridioides difficile Infections, Canada, 2015–2022
Table 2
Characteristics of adult and pediatric community-associated Clostridioides difficile infections, Canada, 2015–2022*
Characteristics | Overall, n = 8,197 | Adult cases, n = 7,845 | Pediatric cases, n = 352 | p value† |
---|---|---|---|---|
Median age, y (IQR) |
66 (52–78) |
67 (54–79) |
10 (4–15) |
|
Sex | ||||
F | 4,525/8,197 (55) | 4,351/7,845 (55) | 174/352 (49) | 0.070 |
M |
3,672/8,197 (45) |
3,494/7,845 (45) |
178/352 (51) |
|
Median length of stay, d (IQR) |
7 (4, 12) |
7 (4, 13) |
5 (2, 8) |
<0.001 |
Treatment | NA | |||
Metronidazole | 2,264/7,497 (30) | 2,100/7,225 (29) | 164/272 (60) | |
Vancomycin | 4,515/7,497 (60) | 4,441/7,225 (61) | 74/272 (27) | |
Metronidazole and vancomycin | 448/7,497 (6.0) | 436/7,225 (6.0) | 12/272 (4.4) | |
Fidaxomicin | 7/7,497 (<0.1) | 7/7,225 (<0.1) | 0/272 | |
Other | 72/7,497 (1.0) | 72/7,225 (1.0) | 0/272 | |
No treatment | 191/7,497 (2.5) | 169/7,225 (2.3) | 22/272 (8.1) | |
FMT referral |
13/4,360 (0.3) |
13/4,228 (0.3) |
0/132 |
>0.9 |
30-day outcomes‡ | ||||
Loop ileostomy§ | 8/874 (0.9) | 8/730 (1.1) | 0/144 | 0.4 |
All-cause mortality | 5/1,473 (6.4) | 95/1,201 (7.9) | 0/272 | <0.001 |
Severe outcome¶ | 71/1,454 (4.9) | 62/1,184 (5.2) | 9/270 (3.3) | 0.2 |
ICU admission for CDI complications | 27/1,482 (1.8) | 22/1,203 (1.8) | 5/279 (1.8) | >0.9 |
Colectomy | 23/1,470 (1.6) | 19/1,193 (1.6) | 4/277 (1.4) | >0.9 |
CDI-attributable death |
30/89 (34) |
30/89 (34) |
0 |
NA |
CDI recurrence# | ||||
Recurrence | 81/1,149 (7.0) | 79/1,065 (7.4) | 2/84 (2.4) | 0.083 |
Median days from primary infection to recurrence (IQR) | 29 (23–38) | 29 (23–38) | 36 (36–36) | 0.5 |
Recurrence length of stay, d (IQR) | 9 (5, 17) | 9 (5, 17) | NA | NA |
Recurrence FMT referral | 0/35 | 0/34 | 0/1 | NA |
Recurrence loop ileostomy | 0/37 | 0/36 | 0/1 | NA |
Recurrence all-cause mortality | 3/67 (4.5) | 3/66 (4.5) | 0/1 | >0.9 |
Recurrence severe outcome¶ | 1/61 (1.6) | 1/61 (1.6) | 0 | NA |
ICU admission for recurrent CDI complications | 0/69 | 0/69 | 0 | NA |
Recurrence-attributable death | 1/2 (50) | 1/2 (50) | 0 | NA |
Recurrence colectomy | 0/68 | 0/67 | 0/1 | NA |
*Values are no. cases/no. in category (%) except as indicated. Denominators for individual case characteristic vary because missing or unknown values were excluded from the analysis. Bold font indicates statistical significance. CDI, C. difficile infection; FMT, fecal microbiota transplant; ICU, intensive care unit; IQR, interquartile range; NA, not applicable. †p value determined by Wilcoxon rank-sum test, Fisher exact test, or Pearson χ2 test. ‡Outcome data was collected during March–April of each calendar year for adult patients and year-round for pediatric patients. §Loop ileostomy added in 2018. ¶Severe outcome was defined as CDI-attributable admission to an intensive care unit, colectomy, or death within 30 d of positive C. difficile specimen where CDI was the cause of death or contributed to death. #Adult and pediatric cases identified during March–April of each calendar year were followed prospectively for 8 weeks for recurrence.