Trends in Clostridioides difficile prevalence, mortality, severity, and age composition during 2003–2014, the national inpatient sample database in the US

BACKGROUND: Clostridioides difficile (formerly known as Clostridium difficile) infection (CDI) is one of the most prevalent healthcare-associated infections in the United States (US). In the early 2000s, CDI emerged as a great threat with increasing prevalence, mortality, and severity, especially in advanced age. We investigated the US national trends in in-hospital CDI prevalence, mortality, severity, and age composition from 2003 to 2014. METHODS: We identified the patients with CDI using the national inpatient sample data from 2003 to 2014. We performed Poisson regression model and Kendall’s tau-b correlation test for our analyses. RESULTS: Adjusted overall CDI prevalence did not significantly change during 2003–2014. In-hospital mortality of overall CDI did not significantly change during 2003–2008, then significantly decreased during 2008–2014. Severity of overall CDI significantly increased during 2003–2008, then decreased during 2008–2014. The proportions of patients with age [Image: see text] 65 years decreased in CDI prevalence, mortality, and severity during 2003–2014. CONCLUSIONS: Compared to the earlier years 2003–2008, overall CDI outcome improved in the later years 2008–2014. Younger patients increasingly contributed to CDI prevalence, mortality, and severity during 2003–2014. More studies to understand underlying driving forces of changes in CDI trends are warranted to mitigate CDI.