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Volume 31, Number 6—June 2025

Research

Characterization of Adult and Pediatric Healthcare-Associated and Community-Associated Clostridioides difficile Infections, Canada, 2015–2022

Tim DuComments to Author , Anada Silva, Kelly B. Choi, Cassandra Lybeck, George R. Golding, Romeo Hizon, Sean Ahmed, Nicole Anderson, Suzanne Bakai-Anderson, Blanda Chow, Ian Davis, Meghan Engbretson, Gerald A. Evans, Charles Frenette, Matthew Garrod, Jennie Johnstone, Kevin C. Katz, Pamela Kibsey, Joanne M. Langley, Jenine Leal, Jenna Leamon, Bonita E. Lee, Diane Lee, Yves Longtin, Dominik Mertz, Jessica Minion, Ericka Oates, Michelle Science, Jocelyn A. Srigley, Kathryn N. Suh, Nisha Thampi, Reena Titoria, Kristen Versluys, Alice Wong, Jeannette L. Comeau, and Susy S. Hota
Author affiliation: National Microbiology Laboratory, Winnipeg, Manitoba, Canada (T. Du, G.R. Golding, R. Hizon, S. Ahmed); Public Health Agency of Canada, Ottawa, Ontario, Canada (A. Silva, K.B. Choi, C. Lybeck, D. Lee); Alberta Health Services, Calgary, Alberta, Canada (N. Anderson, B. Chow, J. Leal, E. Oates); Hamilton Health Sciences, Hamilton, Ontario, Canada (S. Bakai-Anderson, D. Mertz); Queen Elizabeth II Health Sciences Centre, Halifax, Nova Scotia, Canada (I. Davis); Children’s Hospital of Eastern Ontario, Ottawa (M. Engbretson, N. Thampi); Kingston Health Sciences Centre, Kingston, Ontario, Canada (G.A. Evans); McGill University Health Centre, Montreal, Quebec, Canada (C. Frenette); Fraser Health Authority, Vancouver, British Columbia, Canada (M. Garrod); Sinai Health, Toronto, Ontario, Canada (J. Johnstone); North York General Hospital, Toronto (K.C. Katz); Royal Jubilee Hospital, Victoria, British Columbia, Canada (P. Kibsey); IWK Health Centre, Halifax (J.M. Langley); Western Health Authority, Corner Brook, Newfoundland, Canada (J. Leamon); Stollery Children’s Hospital, Edmonton, Alberta, Canada (B.E. Lee); Jewish General Hospital, Montreal (Y. Longtin); Regina General Hospital, Regina, Saskatchewan, Canada (J. Minion); The Hospital for Sick Children, Toronto (M. Science); BC Children’s & Women’s Hospitals, Vancouver (J.A. Srigley); The Ottawa Hospital, Ottawa (K.N. Suh); Provincial Health Services Authority, Vancouver (R. Titoria); Interior Health Authority, Kelowna, British Columbia, Canada (K. Versluys); Royal University Hospital, Saskatoon, Saskatchewan, Canada (A. Wong); Dalhousie University, Halifax (J.L. Comeau); University Health Network, Toronto (S.S. Hota)

Main Article

Table 3

Multivariate regression modeling of epidemiologic factors in characterization of adult and pediatric healthcare-associated and community-associated Clostridioides difficile infections, Canada, 2015–2022*

Characteristics
 Univariable analysis
Multivariable analysis
Odds ratio (95% CI)
 p value
 Odds ratio (95% CI)
 p value
RT027 (n = 438) vs. non-RT027 (n = 4,184) strains
Age group
Adult 3.87 (2.75–5.63) <0.0001 3.42 (2.35–5.18) <0.0001
Pediatric Referent Referent
Sex
F Referent Referent
M 0.97 (0.79–1.17) 0.720 0.97 (0.79–1.20) 0.970
CDI case type
Community-associated Referent Referent
Healthcare-associated 2.16 (1.65–2.89) <0.0001 2.18 (1.64–2.95) <0.0001
Severe CDI† 2.24 (1.71–2.99) <0.0001 2.15 (1.63–2.90) <0.0001
Severe outcome‡
 2.27 (1.56–3.24)
 <0.0001
1.93 (1.31–2.90)
 0.0005
RT106 (n = 606) vs. non-RT106 (n = 4,016) strains
Age group
Adult 0.72 (0.59–0.87) 0.0007 0.71 (0.58–0.88) 0.002
Pediatric Referent Referent
Sex
F Referent Referent
M 0.905 (0.76–1.07) 0.251 0.89 (0.74–1.07) 0.208
CDI case type
Community-associated Referent Referent
Healthcare-associated 0.99 (0.81–1.21) 0.921 1.01 (0.82–1.25) 0.936
Severe CDI† 0.83 (0.69–1.01) 0.0621 0.87 (0.72 – 1.06) 0.168
Severe outcome‡ 0.76 (0.41–1.17) 0.233 0.80 (0.50 – 1.24) 0.345

*Bold font indicates statistical significance. CDI, C. difficile infection. †Severe CDI defined as albumin level <30 g/L, leukocyte count >15 × 109 cells/L, or both. ‡Severe outcome was defined as CDI-attributable admission to an intensive care unit, colectomy, or death within 30 d of first positive C. difficile specimen where CDI was the cause of death or contributed to death.

Main Article

Page created: April 14, 2025
Page updated: May 29, 2025
Page reviewed: May 29, 2025
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