Characterization of Adult and Pediatric Healthcare-Associated and Community-Associated Clostridioides difficile Infections, Canada, 2015–2022

IF 7.2 2区医学 Q1 IMMUNOLOGY

Emerging Infectious Diseases Pub Date : 2025-05-08 DOI:10.3201/eid3106.250182

Tim Du, Anada Silva, Kelly B. Choi, Cassandra Lybeck, George R. Golding, Romeo Hizon, Sean Ahmed, Nicole Anderson, Suzanne Bakai-Anderson, Blanda Chow, Ian Davis, Meghan Engbretson, Gerald A. Evans, Charles Frenette, Matthew Garrod, Jennie Johnstone, Kevin C. Katz, Pamela Kibsey, Joanne M. Langley, Jenine Leal, Jenna Leamon, Bonita E. Lee, Diane Lee, Yves Longtin, Dominik Mertz, Jessica Minion, Ericka Oates, Michelle Science, Jocelyn A. Srigley, Kathryn N. Suh, Nisha Thampi, Reena Titoria, Kristen Versluys, Alice Wong, Jeannette L. Comeau, Susy S. Hota

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Abstract

We investigated epidemiologic and molecular characteristics of healthcare-associated (HA) and community-associated (CA) Clostridioides difficile infection (CDI) among adult and pediatric patients in Canadian Nosocomial Infection Surveillance Program hospitals during 2015–2022. Of 30,824 reported CDI cases, 94.9% (29,250/30,824) were among adult (73.2% HA; 26.8% CA) and 5.1% (1,574/30,824) pediatric (77.6% HA; 22.4% CA) patients. During the study period, adult HA CDI rates decreased by 19.9% and CA CDI rates remained stable; pediatric HA CDI rates decreased by 29.6% and CA CDI decreased by 58.3%. Ribotype (RT) 106 was most common among both groups and replaced RT027 as the predominant strain type. RT027 was most associated with adult patients, HA acquisition, severe CDI, and severe outcomes. Moxifloxacin resistance was higher in adult than pediatric cases; clindamycin and rifampin resistance rates were similar between groups. Continued national surveillance is integral to understanding the epidemiology of adult and pediatric CDI in Canada and informing prevention efforts.

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加拿大2015-2022年成人和儿童医疗保健相关和社区相关艰难梭菌感染的特征

我们调查了2015-2022年加拿大医院感染监测项目医院成人和儿科患者中医疗相关（HA）和社区相关（CA）艰难梭菌感染（CDI）的流行病学和分子特征。在30,824例报告的CDI病例中，94.9%（29,250/30,824）为成人(73.2% HA；26.8% CA)和5.1%（1,574/30,824）儿科(77.6% HA；22.4% CA)患者。在研究期间，成人HA CDI率下降了19.9%，CA CDI率保持稳定；儿童HA CDI率下降29.6%，CA CDI下降58.3%。RT027是两组中最常见的核糖型（rt106）。RT027与成人患者、HA获得、严重CDI和严重结局最相关。莫西沙星耐药率成人高于儿童；两组间克林霉素和利福平耐药率相似。持续的国家监测对于了解加拿大成人和儿童CDI的流行病学以及为预防工作提供信息是不可或缺的。

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来源期刊

Emerging Infectious Diseases 医学-传染病学

CiteScore

17.30

自引率

1.70%

发文量

505

审稿时长

1 months

期刊介绍： Emerging Infectious Diseases is a monthly open access journal published by the Centers for Disease Control and Prevention. The primary goal of this peer-reviewed journal is to advance the global recognition of both new and reemerging infectious diseases, while also enhancing our understanding of the underlying factors that contribute to disease emergence, prevention, and elimination. Targeted towards professionals in the field of infectious diseases and related sciences, the journal encourages diverse contributions from experts in academic research, industry, clinical practice, public health, as well as specialists in economics, social sciences, and other relevant disciplines. By fostering a collaborative approach, Emerging Infectious Diseases aims to facilitate interdisciplinary dialogue and address the multifaceted challenges posed by infectious diseases.