AT IMED 2014

VIENNA (FRONTLINE MEDICAL NEWS) U.S. deaths from Clostridium difficile infection jumped roughly sevenfold from 1999 to 2008, but in the ensuing years (2009-2012), remained stable at about the level first reached in 2008, according to analysis of cause-of-death data from the National Center for Health Statistics.

The increase occurred uniformly across all age groups older than 40 years; among patients 40 years or younger mortality from C. difficile infection remained low, at a rate at or below one death per one million people, Andrew Noymer, Ph.D., reported in a poster at the International Meeting on Emerging Diseases and Surveillance. Among those patients aged 80 years or older, the mortality rate in recent years with C. difficile infection listed as the primary cause exceeded one death per 5,000 people, reported Dr. Noymer , a researcher in population health and disease prevention at the University of California, Irvine.

The mortality data provided no direct insight into the factors contributing to the rise in C. difficile deaths during 1999-2008, but previous reports documented an increased prevalence starting in 2000 of a “hypervirulent” strain of C. difficile circulating in North America and elsewhere ( Critical Care 2008;12:203-10 ).

C. difficile infection as the underlying cause of death rose from less than one age-adjusted occurrence for every 200,000 people in 1999 to about 2.4 age-adjusted deaths per 100,000 in 2008, and then remained at about that level through 2012. Rates were similar in women and men.

When analyzed as any mention of C. difficile infection with another factor cited as the primary cause of death occurrences also rose roughly sevenfold from 1999 to 2008, from about one death for every 200,000 people to about 3.5 deaths per 100,000.

When C. difficile has been a contributing factor, the wide spectrum of causes of death that it can accompany “reads like a who’s who of conditions requiring inpatient clinical care,” Dr. Noymer said. “Given the nosocomial nature of C. difficile this is not surprising.”

The top three lethal conditions with C. difficile complication were atherosclerotic heart disease, chronic obstructive pulmonary disease, and septicemia.

Dr. Noymer had no disclosures.