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Clostridium difficile Infection Among Veterans Health Administration Patients

Published online by Cambridge University Press:  05 June 2015

Yinong Young-Xu ,
Jennifer L Kuntz ,
Dale N. Gerding ,
Julia Neily ,
Peter Mills ,
Erik R. Dubberke ,
Margaret A. Olsen ,
Ciarán P. Kelly  and
Cédric Mahé
Yinong Young-Xu*
Affiliation:
National Center for Patient Safety, Department of Veterans Affairs, White River Junction, Vermont, United States Geisel School of Medicine at Dartmouth, Hanover, New Hampshire, United States
Jennifer L Kuntz
Affiliation:
Kaiser Permanente Northwest Center for Health Research, Portland, Oregon, United States
Dale N. Gerding
Affiliation:
Edward Hines Jr. Veterans Affairs Hospital, Hines, Illinois and Loyola University Chicago Stritch School of Medicine, Maywood, Illinois, United States
Julia Neily
Affiliation:
National Center for Patient Safety, Department of Veterans Affairs, White River Junction, Vermont, United States
Peter Mills
Affiliation:
National Center for Patient Safety, Department of Veterans Affairs, White River Junction, Vermont, United States Geisel School of Medicine at Dartmouth, Hanover, New Hampshire, United States
Erik R. Dubberke
Affiliation:
Department of Medicine, Washington University School of Medicine, St. Louis, Missouri, United States
Margaret A. Olsen
Affiliation:
Department of Medicine, Washington University School of Medicine, St. Louis, Missouri, United States Department of Surgery, Washington University School of Medicine, St. Louis, Missouri, United States
Ciarán P. Kelly
Affiliation:
Division of Gastroenterology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts, United States
Cédric Mahé
Affiliation:
Sanofi-Pasteur, Lyon, France
*
Address correspondence to Yinong Young-Xu, ScD, MA, MS, VAMC (10A4E), 215 North Main Street, White River Junction, VT, 05009 (Yinong.Young-Xu@va.gov).
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Abstract

OBJECTIVE

To report on the prevalence and incidence of Clostridium difficile infection (CDI) from 2009 to 2013 among Veterans Healthcare Administration patients

DESIGN

A retrospective descriptive analysis of data extracted from a large electronic medical record (EMR) database

SETTING

Data were acquired from VHA healthcare records from 2009 to 2013 that included outpatient clinical visits, long-term care, and hospitalized care as well as pharmacy and laboratory information.

RESULTS

In 2009, there were 10,207 CDI episodes, and in 2013, there were 12,143 CDI episodes, an increase of 19.0%. The overall CDI rate increased by 8.4% from 193 episodes per 100,000 patient years in 2009 to 209 episodes per 100,000 patient years in 2013. Of the CDI episodes identified in 2009, 58% were identified during a hospitalization, and 42% were identified in an outpatient setting. In 2013, 44% of the CDI episodes were identified in an outpatient setting.

CONCLUSION

This is one of the largest studies that has utilized timely EMR data to describe the current CDI epidemiology at the VHA. Despite an aging population with greater burden of comorbidity than the general US population, our data show that VHA CDI rates stabilized between 2011 and 2013 following increases likely attributable to the introduction of the more sensitive nucleic acid amplification tests (NAATs). The findings in this report will help establish an accurate benchmark against which both current and future VA CDI prevention initiatives can be measured.

Infect. Control Hosp. Epidemiol. 2015;36(9):1038–1045

Type
Original Articles
Information
Infection Control & Hospital Epidemiology , Volume 36 , Issue 9 , September 2015 , pp. 1038 - 1045
Copyright
© 2015 by The Society for Healthcare Epidemiology of America. All rights reserved 

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Footnotes

This work represents the opinions of the authors and does not necessarily represent the views of the Department of Veterans Affairs or the US government.

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