Clostridioides difficile infection-associated cause-specific and all-cause mortality: a population-based cohort study

Area of Science:

• Infectious Diseases
• Epidemiology
• Public Health

Background:

• Clostridioides difficile infection (CDI) is a major cause of healthcare-associated infections and mortality globally.
• Existing data on CDI-associated mortality are limited, necessitating further investigation.
• Understanding factors contributing to CDI mortality is crucial for public health strategies.

Purpose of the Study:

• To investigate the association between CDI and all-cause mortality.
• To examine cause-specific mortality in individuals with CDI.
• To explore the influence of recurrent CDI, acquisition setting, comorbidities, and age on CDI-related mortality.

Main Methods:

• A nationwide population-based cohort study in Sweden (2006-2019).
• Comparison of individuals with CDI against the general Swedish population using standardized mortality ratios.
• Matched-cohort analysis (1:10) with multivariable Poisson regression to determine incidence rate ratios (IRRs).

Main Results:

• CDI was linked to a 3- to 7-fold increased mortality rate (IRR=3.5, SMR=6.8).
• Hospital-acquired CDI showed higher mortality rates (IRR=2.4).
• Mortality remained elevated even after adjusting for comorbidities, particularly in those without chronic conditions.

Conclusions:

• CDI is associated with significantly elevated all-cause and cause-specific mortality.
• Increased mortality risk persists across all sexes, age groups, and comorbidity levels.
• CDI poses a substantial mortality burden, independent of underlying health status.