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Clostridium difficile-associated diarrhoea: epidemiological data from Western Australia

T V Riley1, G L O'Neill, R A Bowman

  • 1Health Services Statistics and Epidemiology Branch, Health Department of Western Australia, East Perth.

Epidemiology and Infection
|August 1, 1994
PubMed
Summary

Clostridium difficile-associated diarrhoea (CDAD) incidence increased significantly from 1983-1990, primarily affecting elderly females. Stool culture proved more sensitive than cytotoxin detection for diagnosing CDAD.

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Area of Science:

  • Infectious Diseases
  • Hospital Epidemiology
  • Microbiology

Background:

  • Clostridium difficile-associated diarrhoea (CDAD) is a significant healthcare-associated infection.
  • Understanding incidence trends and risk factors is crucial for effective infection control.

Purpose of the Study:

  • To investigate the incidence, demographics, and potential influencing factors of CDAD.
  • To compare the diagnostic sensitivity of stool culture versus cytotoxin detection for C. difficile.

Main Methods:

  • Retrospective analysis of CDAD cases at a teaching hospital from 1983-1992.
  • Laboratory diagnosis using stool culture and/or cytotoxin detection.
  • Analysis of patient age, sex, seasonal trends, and environmental factors.

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Main Results:

  • A significant increasing trend in CDAD incidence was observed from 1983 to 1990.
  • The majority of affected patients were elderly (≥60 years) and female.
  • Stool culture identified C. difficile in 60% of cases where cytotoxin was not detected, indicating higher sensitivity.

Conclusions:

  • CDAD incidence rose notably during the study period, particularly in elderly females.
  • Stool culture is a more sensitive diagnostic method for C. difficile than cytotoxin detection.
  • Further investigation into infection control, environmental contamination, and antibiotic use is warranted.