The Global Burden of <i>Clostridioides difficile</i> Infections, 2016–2024: A Systematic Review and Meta-Analysis

<b>Background</b>: <i>Clostridioides difficile</i> infection (CDI) is a major cause of healthcare-associated infections globally. Understanding variations in CDI incidence and outcomes across settings, populations, and regions is important for guiding prevention strategies. &...

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Main Authors: Rachel A. A. Akorful, Alex Odoom, Aaron Awere-Duodu, Eric S. Donkor
Format: Article
Language:English
Published: MDPI AG 2025-04-01
Series:Infectious Disease Reports
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Online Access:https://www.mdpi.com/2036-7449/17/2/31
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author Rachel A. A. Akorful
Alex Odoom
Aaron Awere-Duodu
Eric S. Donkor
author_facet Rachel A. A. Akorful
Alex Odoom
Aaron Awere-Duodu
Eric S. Donkor
author_sort Rachel A. A. Akorful
collection DOAJ
description <b>Background</b>: <i>Clostridioides difficile</i> infection (CDI) is a major cause of healthcare-associated infections globally. Understanding variations in CDI incidence and outcomes across settings, populations, and regions is important for guiding prevention strategies. <b>Aim</b>: The aim of this study was to determine the global epidemiology of CDI to better understand disease burden across settings and geographic regions. <b>Methods</b>: Relevant publications were identified through searches of major databases, including PubMed, Scopus, and Web of Science, published from 1 January 2016 through 24 July 2024. Random effects models were used to pool estimates, and 95% confidence intervals (CIs) were calculated. <b>Results</b>: A total of 59 studies, representing 24 countries across North America, Europe, the Asia–Pacific region, Latin America, and the Middle East, met the inclusion criteria. The incidence of CDI was highest in hospital-onset healthcare facility settings, with 5.31 cases/1000 admissions (95% CI 3.76–7.12) and 5.00 cases/10,000 patient-days (95% CI 3.96–6.15). Long-term care facilities reported 44.24 cases/10,000 patient-days (95% CI 39.57–49.17). Pediatric populations faced a greater risk, with 4.52 cases/1000 admissions (95% CI 0.55–12.17), than adults did at 2.13 (95% CI 1.69–2.61). Recurrence rates were highest for community-acquired CDI at 16.22%. The death rates for the CDI cases tracked for 30 days and of unspecified duration were 8.32% and 16.05%, respectively. <b>Conclusions</b>: This comprehensive review identified healthcare facilities, long-term care, pediatric populations, and North America as disproportionately burdened. This finding provides guidance on priority areas and populations for targeted prevention through antimicrobial stewardship, infection control, and surveillance.
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spelling doaj-art-a037c3f8f05747cca33e3bfc7ec6cb212025-08-20T03:13:47ZengMDPI AGInfectious Disease Reports2036-74492025-04-011723110.3390/idr17020031The Global Burden of <i>Clostridioides difficile</i> Infections, 2016–2024: A Systematic Review and Meta-AnalysisRachel A. A. Akorful0Alex Odoom1Aaron Awere-Duodu2Eric S. Donkor3Department of Medical Microbiology, University of Ghana Medical School, Korle Bu, Accra P.O. Box KB 4236, GhanaDepartment of Medical Microbiology, University of Ghana Medical School, Korle Bu, Accra P.O. Box KB 4236, GhanaDepartment of Medical Microbiology, University of Ghana Medical School, Korle Bu, Accra P.O. Box KB 4236, GhanaDepartment of Medical Microbiology, University of Ghana Medical School, Korle Bu, Accra P.O. Box KB 4236, Ghana<b>Background</b>: <i>Clostridioides difficile</i> infection (CDI) is a major cause of healthcare-associated infections globally. Understanding variations in CDI incidence and outcomes across settings, populations, and regions is important for guiding prevention strategies. <b>Aim</b>: The aim of this study was to determine the global epidemiology of CDI to better understand disease burden across settings and geographic regions. <b>Methods</b>: Relevant publications were identified through searches of major databases, including PubMed, Scopus, and Web of Science, published from 1 January 2016 through 24 July 2024. Random effects models were used to pool estimates, and 95% confidence intervals (CIs) were calculated. <b>Results</b>: A total of 59 studies, representing 24 countries across North America, Europe, the Asia–Pacific region, Latin America, and the Middle East, met the inclusion criteria. The incidence of CDI was highest in hospital-onset healthcare facility settings, with 5.31 cases/1000 admissions (95% CI 3.76–7.12) and 5.00 cases/10,000 patient-days (95% CI 3.96–6.15). Long-term care facilities reported 44.24 cases/10,000 patient-days (95% CI 39.57–49.17). Pediatric populations faced a greater risk, with 4.52 cases/1000 admissions (95% CI 0.55–12.17), than adults did at 2.13 (95% CI 1.69–2.61). Recurrence rates were highest for community-acquired CDI at 16.22%. The death rates for the CDI cases tracked for 30 days and of unspecified duration were 8.32% and 16.05%, respectively. <b>Conclusions</b>: This comprehensive review identified healthcare facilities, long-term care, pediatric populations, and North America as disproportionately burdened. This finding provides guidance on priority areas and populations for targeted prevention through antimicrobial stewardship, infection control, and surveillance.https://www.mdpi.com/2036-7449/17/2/31<i>Clostridioides difficile</i>incidencerisk factorsepidemiologysystematic reviewhealthcare-associated
spellingShingle Rachel A. A. Akorful
Alex Odoom
Aaron Awere-Duodu
Eric S. Donkor
The Global Burden of <i>Clostridioides difficile</i> Infections, 2016–2024: A Systematic Review and Meta-Analysis
Infectious Disease Reports
<i>Clostridioides difficile</i>
incidence
risk factors
epidemiology
systematic review
healthcare-associated
title The Global Burden of <i>Clostridioides difficile</i> Infections, 2016–2024: A Systematic Review and Meta-Analysis
title_full The Global Burden of <i>Clostridioides difficile</i> Infections, 2016–2024: A Systematic Review and Meta-Analysis
title_fullStr The Global Burden of <i>Clostridioides difficile</i> Infections, 2016–2024: A Systematic Review and Meta-Analysis
title_full_unstemmed The Global Burden of <i>Clostridioides difficile</i> Infections, 2016–2024: A Systematic Review and Meta-Analysis
title_short The Global Burden of <i>Clostridioides difficile</i> Infections, 2016–2024: A Systematic Review and Meta-Analysis
title_sort global burden of i clostridioides difficile i infections 2016 2024 a systematic review and meta analysis
topic <i>Clostridioides difficile</i>
incidence
risk factors
epidemiology
systematic review
healthcare-associated
url https://www.mdpi.com/2036-7449/17/2/31
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