Trends in incidence and clinical outcomes of Clostridioides difficile infection, Hong Kong

• Main Authors: Guo, Cosmos L. T., Kwong, Thomas N. Y., Mak, Joyce W. Y., Zhang, Lin, Lui, Grace C. Y., Wong, Grace L. H., Ip, Margaret, Yu, Jun, Sung, Joseph Jao Yiu, Wu, William K. K., Wong, Sunny Hei
• Other Authors: Lee Kong Chian School of Medicine (LKCMedicine)
• Format: Article
• Language: English
• Published: 2022
• Subjects: Science::Medicine; Clostridioides Difficile; Hong Kong
• Online Access: https://hdl.handle.net/10356/160093
• Institution: Nanyang Technological University

We conducted a territorywide survey to investigate the epidemiology, risk factors, and clinical outcomes of Clostridioides difficile infection (CDI) among hospitalized patients in Hong Kong. A total of 17,105 cases of CDI were identified, of which 15,717 (91.9%) were healthcare-associated and 1,025 (6.0%) were community-associated. Although CDI incidence increased substantially from 2006 to 2017, it plateaued in 2018 and 2019. The 30-day mortality rates decreased from 20.1% in 2015 to 16.8% in 2019, whereas the 60-day recurrence rates remained constant at ≈11% during the study period. Cross-correlation statistic showed significant correlations between incidence trend and overall antimicrobial drug use (r = 0.865, p<0.001), which has decreased as a result of an antibiotic stewardship program initiated in 2017. Our data suggest a turning point in C. difficile epidemiology that could be related to the changing pattern of antimicrobial drug use.