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Epidemiology of Clostridioides difficile infection in Canada: A six-year review to support vaccine decision-making.


ABSTRACT: Background:Two vaccines against Clostridioides difficile infections (CDI) are currently in phase III trials. To enable decision-making on their use in public health programs, national disease epidemiology is necessary. Objectives:To determine the epidemiology of hospital-acquired CDI (HA-CDI) and community-associated CDI (CA-CDI) in Canada using provincial surveillance data and document discrepancies in CDI-related definitions among provincial surveillance programs. Methods:Publicly-available CDI provincial surveillance data from 2011 to 2016 that distinguished between HA-CDI and CA-CDI were included and the most common surveillance definitions for each province were used. The HA-, CA-CDI incidence rates and CA-CDI proportions (%) were calculated for each province. Both HA- and CA-CDI incidence rates were examined for trends. Types of disparities were summarized and detailed discrepancies were documented. Results:Canadian data were analyzed from nine provinces. The HA-CDI rates ranged from 2.1/10,000 to 6.5/10,000 inpatient-days, with a decreasing trend over time. Available data on CA-CDI showed that both rates and proportions have been increasing over time. Discrepancies among provincial surveillance definitions were documented in CDI case classifications, surveillance populations and rate calculations. Conclusion:In Canada overall, the rate of HA-CDI has been decreasing and the rate of CA-CDI has been increasing, although this calculation was impeded by discrepancies in CDI-related definitions among provincial surveillance programs. Nationally-adopted common definitions for CDI would enable better comparisons of CDI rates between provinces and a calculation of the pan-Canadian burden of illness to support vaccine decision-making.

SUBMITTER: Xia Y 

PROVIDER: S-EPMC6615439 | biostudies-literature | 2019 Jul

REPOSITORIES: biostudies-literature

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Epidemiology of <i>Clostridioides difficile</i> infection in Canada: A six-year review to support vaccine decision-making.

Xia Y Y   Tunis M C MC   Frenette C C   Katz K K   Amaratunga K K   Rose S Rhodenizer SR   House A A   Quach C C  

Canada communicable disease report = Releve des maladies transmissibles au Canada 20190704 7-8


<h4>Background</h4>Two vaccines against <i>Clostridioides difficile</i> infections (CDI) are currently in phase III trials. To enable decision-making on their use in public health programs, national disease epidemiology is necessary.<h4>Objectives</h4>To determine the epidemiology of hospital-acquired CDI (HA-CDI) and community-associated CDI (CA-CDI) in Canada using provincial surveillance data and document discrepancies in CDI-related definitions among provincial surveillance programs.<h4>Meth  ...[more]

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