Incidence, case fatality and genotypes causing Clostridium difficile infections, Finland, 2008

Area of Science:

• Infectious Diseases
• Epidemiology
• Molecular Epidemiology

Background:

• The epidemiology of Clostridium difficile infections (CDI) has shifted globally since 2000.
• Population-based data on CDI incidence and case fatality remain limited.
• Understanding regional variations and molecular characteristics is crucial for effective control.

Purpose of the Study:

• To assess the incidence and case fatality of CDI in Finland using nationwide surveillance data from 2008.
• To identify regional differences in CDI epidemiology.
• To correlate epidemiological findings with molecular typing data, including the prevalence of specific PCR ribotypes.

Main Methods:

• Analysis of nationwide laboratory-based surveillance data for CDI episodes in Finland during 2008.
• Calculation of incidence and 30-day case fatality rates, stratified by age and region.
• Genotyping of Clostridium difficile isolates using PCR ribotyping to identify prevalent strains.

Main Results:

• A total of 6201 CDI episodes were identified, with an overall incidence of 118.3 per 100,000 population.
• Incidence and 30-day case fatality increased significantly with age, peaking in individuals over 84 years old.
• PCR ribotype 027 was prevalent (36% of typed isolates) and found in multiple regions, alongside other types like 001, 002, and 014.

Conclusions:

• CDI incidence and case fatality rates in Finland are highest among the elderly and exhibit significant regional variation.
• The uneven distribution of hypervirulent strains, such as PCR ribotype 027, may contribute to observed epidemiological disparities.
• Regional differences in diagnostic practices and patient demographics could also influence the reported incidence and outcomes of CDI.