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. 2024 Jul 28;60(8):1222.
doi: 10.3390/medicina60081222.

Mortality Attributable to Clostridioides difficile Infection: The Rising Burden of Disease in European Countries

Irena Ilic  1 , Ivana Zivanovic Macuzic  2 , Milena Ilic  3
Affiliations

Mortality Attributable to Clostridioides difficile Infection: The Rising Burden of Disease in European Countries

Irena Ilic et al. Medicina (Kaunas). .

Abstract

Background and Objectives: Clostridioides difficile infection is a major public health issue, being among the main causes of mortality due to healthcare-associated diarrhea. This study aimed to assess the trends in mortality attributable to Clostridioides difficile infections in European countries over a period of 30 years. Materials and Methods: A descriptive epidemiological study was conducted, with the application of an ecological study design, to evaluate the trends in mortality due to Clostridioides difficile infection in the Central, Eastern, and Western European sub-regions from 1990 to 2019. The Global Burden of Disease study database was used. Trends were evaluated with the joinpoint regression analysis. Results: In both sexes, about 76% of all deaths attributable to Clostridioides difficile infections were recorded in the Western European sub-region in 2019. The age-standardized rates of the burden of Clostridioides difficile infection in 2019 were the highest in the Central European sub-region, followed by the Western European sub-region, while the lowest rates were observed in the Eastern European sub-region. A significantly increasing trend in mortality attributable to Clostridioides difficile infection from 1990 to 2019 was recorded both in males (by +2.1% per year) and females (by +2.8% per year). The burden of Clostridioides difficile infection showed increasing trends in most of the European countries, significantly correlating with the country's development, according to the Human Development Index. Conclusions: The rising burden of Clostridioides difficile infection in European countries in the last few decades suggests a need for improving public health measures, with a focus both on the hospital setting and community.

Keywords: Clostridium difficile; epidemiology; mortality; trends.

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Conflict of interest statement

The authors declare no conflicts of interest.

Figures

Figure 1
Figure 1
Number of deaths attributable to Clostridioides difficile infections in both sexes in European countries, 1990–2019. Source: Global Burden of Disease estimates [17].
Figure 2
Figure 2
Number of deaths attributable to Clostridioides difficile infections in the Central, Eastern, and Western European sub-regions, by sexes, in 2019. Source: Global Burden of Disease estimates [17].
Figure 3
Figure 3
Mortality attributable to Clostridioides difficile infection in the Central, Eastern, and Western European sub-regions, by sexes, in 2019. Source: Global Burden of Disease estimates [17].
Figure 4
Figure 4
Trends in mortality and years of life lost due to Clostridioides difficile infection in the Central, Eastern, and Western European sub-regions as a whole, 1990–2019: a joinpoint regression analysis. * Statistically significant trend (p < 0.05); APC = Annual Percentage Change; AAPC, for full period presented AAPC (Average Annual Percent Change); CI = Confidence Interval. Source: Global Burden of Disease estimates [17].
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