ArticleOpen forum infectious diseases2014
Determinants of Clostridium difficile Infection Incidence Across Diverse United States Geographic Locations.
Article in Open forum infectious diseases, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 31 papers, 3 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
31 citing papers in PubMed, 3 syntheses or guidelines pooled it, 50 citations in OpenAlex.
- Epidemiologic profile of community-acquiredEpidemiology and infection · 2025Pooled it
- Incidence and Outcomes Associated With Clostridium difficile Infections: A Systematic Review and Meta-analysis.JAMA network open · 2020Pooled it
- Global burden ofJournal of global health · 2019Pooled it
- Clostridioides difficile in West Africa: a systematic review of the limited evidence and key knowledge gaps.Global epidemiology · 2026Article
- Variety ofGerms · 2026Article
- Clinical epidemiology and risk factors of herpes zoster in Türkiye: a decade-long, multicenter retrospective cohort study.BMC infectious diseases · 2026Article
- Trends and Disparities inGastroenterology research and practice · 2026Article
- Effects of Sexual Dimorphism and the Estrous Cycle onACS infectious diseases · 2025Article
- Factors associated with failure of fecal microbiota transplant for recurrentTherapeutic advances in gastroenterology · 2025Article
- The sympathetic nervous system drives hyperinflammatory responses to Clostridioides difficile infection.Cell reports. Medicine · 2024Article
- Article
- Potential underreporting of treated patients using aInfection control and hospital epidemiology · 2024Observational
- Article
- Association between epidemiologic case definition categories and adverse clinical outcome in patients with Clostridiodes difficile infection in San Francisco County, California: a five-year retrospective cohort study.BMC infectious diseases · 2023Article
- Clostridioides difficile Infection in Hospitalized Pediatric Patients: Comparisons of Epidemiology, Testing, and Treatment from 2013 to 2019.The Journal of pediatrics · 2023Article
- Prevalence of diagnostically-discrepantFrontiers in medicine · 2023Article
- Comparison of the Risk of RecurrentOpen forum infectious diseases · 2022Article
- Article
- Health care resource utilization and costs of recurrentJournal of managed care & specialty pharmacy · 2021Article
- Optimization of an Assay To Determine Colonization Resistance to Clostridioides difficile in Fecal Samples from Healthy Subjects and Those Treated with Antibiotics.Antimicrobial agents and chemotherapy · 2020Article
Corrections and comments
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Authors and funding
12 authors at 10 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundClostridium difficile infection (CDI) is no longer restricted to hospital settings, and population-based incidence measures are needed. Understanding the determinants of CDI incidence will allow for more meaningful comparisons of rates and accurate national estimates.
methodsData from active population- and laboratory-based CDI surveillance in 7 US states were used to identify CDI cases (ie, residents with positive C difficile stool specimen without a positive test in the prior 8 weeks). Cases were classified as community-associated (CA) if stool was collected as outpatients or ≤3 days of admission and no overnight healthcare facility stay in the past 12 weeks; otherwise, cases were classified as healthcare-associated (HA). Two regression models, one for CA-CDI and another for HA-CDI, were built to evaluate predictors of high CDI incidence. Site-specific incidence was adjusted based on the regression models.
resultsOf 10 062 cases identified, 32% were CA. Crude incidence varied by geographic area; CA-CDI ranged from 28.2 to 79.1/100 000 and HA-CDI ranged from 45.7 to 155.9/100 000. Independent predictors of higher CA-CDI incidence were older age, white race, female gender, and nucleic acid amplification test (NAAT) use. For HA-CDI, older age and a greater number of inpatient-days were predictors. After adjusting for relevant predictors, the range of incidence narrowed greatly; CA-CDI rates ranged from 30.7 to 41.3/100 000 and HA-CDI rates ranged from 58.5 to 94.8/100 000.
conclusionsDifferences in CDI incidence across geographic areas can be partially explained by differences in NAAT use, age, race, sex, and inpatient-days. Variation in antimicrobial use may contribute to the remaining differences in incidence.
Identifiers
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.