Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2015 Jun 3;2(3):ofv076.
doi: 10.1093/ofid/ofv076. eCollection 2015 Sep.

Incidence and Costs of Clostridium difficile Infections in Canada

Adrian R Levy  1 , Shelagh M Szabo  2 , Greta Lozano-Ortega  2 , Elisa Lloyd-Smith  3 , Victor Leung  4 , Robin Lawrence  5 , Marc G Romney  4
Affiliations

Incidence and Costs of Clostridium difficile Infections in Canada

Adrian R Levy et al. Open Forum Infect Dis. .

Abstract

Background. Limited data are available on direct medical costs and lost productivity due to Clostridium difficile infection (CDI) in Canada. Methods. We developed an economic model to estimate the costs of managing hospitalized and community-dwelling patients with CDI in Canada. The number of episodes was projected based on publicly available national rates of hospital-associated CDI and the estimate that 64% of all CDI is hospital-associated. Clostridium difficile infection recurrences were classified as relapses or reinfections. Resource utilization data came from published literature, clinician interviews, and Canadian CDI surveillance programs, and this included the following: hospital length of stay, contact with healthcare providers, pharmacotherapy, laboratory testing, and in-hospital procedures. Lost productivity was considered for those under 65 years of age, and the economic impact was quantified using publicly available labor statistics. Unit costs were obtained from published sources and presented in 2012 Canadian dollars. Results. There were an estimated 37 900 CDI episodes in Canada in 2012; 7980 (21%) of these were relapses, out of a total of 10 900 (27%) episodes of recurrence. The total cost to society of CDI was estimated at $281 million; 92% ($260 million) was in-hospital costs, 4% ($12 million) was direct medical costs in the community, and 4% ($10 million) was due to lost productivity. Management of CDI relapses alone accounted for $65.1 million (23%). Conclusions. The largest proportion of costs due to CDI in Canada arise from extra days of hospitalization. Interventions reducing the severity of infection and/or relapses leading to rehospitalizations are likely to have the largest absolute effect on direct medical costs.

Keywords: Clostridium difficile; economic burden; epidemiology; hospital-acquired infections; model.

PubMed Disclaimer

Figures

Figure 1.
Figure 1.
Estimated number of infections and of Clostridium difficile in Canada in 2012, base infection assumptions and sensitivity analysis.
Figure 2.
Figure 2.
Estimated number of infections and of Clostridium difficile in Canadian provinces and Territories in 2012.
See this image and copyright information in PMC

References

    1. Gravel D, Miller M, Simor A et al. . Health care-associated Clostridium difficile infection in adults admitted to acute care hospitals in Canada: a Canadian nosocomial infection surveillance program study. Clin Infect Dis 2009; 48:568–76. - PubMed
    1. McDonald LC, Owings M, Jernigan DB. Clostridium difficile infection in patients discharged from US short-stay hospitals, 1996–2003. Emerg Infect Dis 2006; 12:409–15. - PMC - PubMed
    1. Redelings MD, Sorvillo F, Mascola L. Increase in Clostridium difficile-related mortality rates, United States, 1999–2004. Emerg Infect Dis 2007; 13:1417–9. - PMC - PubMed
    1. Cartman ST, Heap JT, Kuehne SA et al. . The emergence of ‘hypervirulence’ in Clostridium difficile. Int J Med Microbiol 2010; 300:387–95. - PubMed
    1. Collins DA, Hawkey PM, Riley TV. Epidemiology of Clostridium difficile infection in Asia. Antimicrob Resist Infect Control 2013; 2:21. - PMC - PubMed