Changing Epidemiology of Clostridium difficile-Associated Disease

Abstract

Recent reports suggest that the frequency and severity of Clostridium difficile-associated disease (CDAD) may be increasing. In March and November 2004, the Infectious Diseases Society of America Emerging Infections Network surveyed 841 infectious diseases consultants about their experiences with CDAD. Of 447 US respondents reporting cases on the first survey, 29% perceived an increase in CDAD frequency; 29%, increased severity; 34%, increased recurrences; and 31%, increased refractoriness to therapy. On the second survey, 221 infectious diseases consultants reported "no change" in their experience during the prior 6 months. Of the remainder, including 76 new respondents and 90 respondents whose experience had changed, 41% perceived an increase in CDAD frequency; 46%, increased severity; 64%, increased recurrences; and 48%, increased disease refractory to therapy. In summary, 29% or more of infectious disease consultants practicing in the United States reported increased caseloads and more severe, recalcitrant, or recurrent CDAD during 2003 to 2004.