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. 2019 Aug;24(35):1800638.
doi: 10.2807/1560-7917.ES.2019.24.35.1800638.

Epidemiology of Clostridioides difficile infections, France, 2010 to 2017

Mélanie Colomb-Cotinat  1   2 , Laetitia Assouvie  1   2 , Julien Durand  1 , Côme Daniau  1 , Lucie Leon  1 , Sylvie Maugat  1 , Sophan Soing-Altrach  1 , Cécile Gateau  3 , Jeanne Couturier  3 , Isabelle Arnaud  4 , Pascal Astagneau  4 , Anne Berger-Carbonne  1 , Frédéric Barbut  3
Affiliations

Epidemiology of Clostridioides difficile infections, France, 2010 to 2017

Mélanie Colomb-Cotinat et al. Euro Surveill. 2019 Aug.

Abstract

BackgroundClostridioides difficile is a leading cause of healthcare-associated diarrhoea in middle and high-income countries. Up to 2018, there has been no systematic, annual surveillance for C. difficile infections (CDI) in France.AimsTo provide an updated overview of the epidemiology of CDI in France between 2010 and 2017 based on five different data sources.MethodsThis is a descriptive study of retrospective surveillance and alerts data. Incidence of CDI cases was estimated through the CDI incidence survey (2016) and data from the French National Uniform Hospital Discharge Database (PMSI; 2010-16). Testing frequency for CDI was estimated through the CDI incidence survey and point prevalence studies on healthcare-associated infections (HAI; 2012 and 2017). The national early warning response system for HAI (HAI-EWRS, 2012-17) and National Reference Laboratory data (2012-17) were used to follow the number of severe CDI cases and/or outbreaks.ResultsIn 2016, CDI incidence in acute care was 3.6 cases per 10,000 patient days (PD). There was a statistically significant increase in CDI incidence between 2010 and 2016 (+ 14% annually) and testing frequency was 47.4 per 10,000 PD. The number of CDI HAI-EWRS notifications decreased between 2015 and 2017 with only a few large outbreaks reported.ConclusionThe CDI incidence estimate increased from 2010, but remained below the European average of 7 per 10,000 PD in 2014; there were fewer severe cases or clusters reported in France. The consistency between PMSI and laboratory-based estimated CDI incidence could allow for more routine monitoring of CDI incidence.

Keywords: CDI incidence survey; Clostridioides difficile infections; France; PMSI; epidemiology.

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Conflict of interest statement

Conflict of interest: None declared.

Figures

Figure 1
Figure 1
Number and incidence of hospital stays with CDI, France, PMSI data 2010–2016
Figure 2
Figure 2
Regional incidence of CDI stays, France, PMSI data 2010 and 2016
Figure 3
Figure 3
Number of HAI-EWRS notifications and cases with CDI, France, 2012–2017
See this image and copyright information in PMC

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