Trends in the epidemiology of Clostridioides difficile infection in Germany
- 10 May 2023
- journal article
- research article
- Published by Springer Science and Business Media LLC in Infection
- Vol. 51 (6), 1695-1702
- https://doi.org/10.1007/s15010-023-02044-5
Abstract
Purposes Despite reports of a declining incidence over the last decade, Clostridioides difficile infection (CDI) is still considered the most important healthcare-associated causes of diarrhea worldwide. In Germany, several measures have been taken to observe, report, and influence this development. This report aims to analyze the development of hospital coding for CDI in Germany over the last decade and to use it to estimate the public health burden caused by CDI. Methods Reports from the Institute for Hospital Remuneration Systems, German Federal Statistical Office (DESTATIS), the Robert-Koch-Institute (RKI), Saxonian authorities and hospital quality reports during 2010–2021 were examined for CDI coding and assessed in a structured expert consultation. Analysis was performed using 2019 versions of Microsoft Excel® and Microsoft Access®. Results Peaks of 32,203 cases with a primary diagnosis (PD) of CDI and 78,648 cases with a secondary diagnosis (SD) of CDI were observed in 2015. The number of cases had decreased to 15,412 PD cases (− 52.1%) and 40,188 SD cases (− 48.9%) by 2021. These results were paralleled by a similar decline in notifiable severe cases. However, average duration of hospitalization of the cases remained constant during this period. Conclusions Hospital coding of CDI and notification to authorities has approximately halved from 2015 to 2021. Potential influential factors include hospital hygiene campaigns, implementation of antibiotic stewardship programs, social distancing due to the COVID-19 pandemic, and a decrease in more pathogenic subtypes of bacteria. Further research is necessary to validate the multiple possible drivers for this development.Keywords
Funding Information
- Ferring Arzneimittel GmbH
This publication has 46 references indexed in Scilit:
- The Roles of Clostridium difficile and Norovirus Among Gastroenteritis-Associated Deaths in the United States, 1999–2007Clinical Infectious Diseases, 2012
- The economic burden of Clostridium difficileClinical Microbiology & Infection, 2012
- High Prevalence of Clostridium difficile Colonization among Nursing Home Residents in Hesse, GermanyPLOS ONE, 2012
- Frequent Hospital Readmissions for Clostridium difficile Infection and the Impact on Estimates of Hospital-Associated C. difficile BurdenInfection Control & Hospital Epidemiology, 2012
- Consequences of Clostridium difficile infection: understanding the healthcare burdenClinical Microbiology & Infection, 2012
- The Changing Epidemiology of Clostridium difficile InfectionsClinical Microbiology Reviews, 2010
- Clostridium difficile infection: new developments in epidemiology and pathogenesisNature Reviews Microbiology, 2009
- Surveillance of Clostridium difficile-associated diarrhoea with the German nosocomial infection surveillance system KISS (CDAD-KISS)International Journal of Antimicrobial Agents, 2009
- Clostridium difficileSurveillance Trends, Saxony, GermanyEmerging Infectious Diseases, 2008
- Emergence of Clostridium difficile-associated disease in North America and EuropeClinical Microbiology & Infection, 2006