Volume 23, Number 10—October 2017
Research
Disease Burden of Clostridium difficile Infections in Adults, Hong Kong, China, 2006–2014
Jeffery Ho1, Rudin Z.W. Dai1, Thomas N.Y. Kwong, Xiansong Wang, Lin Zhang, Margaret Ip, Raphael Chan, Peter M.K. Hawkey, Kelvin L.Y. Lam, Martin C.S. Wong, Gary Tse, Matthew T.V. Chan, Francis K.L. Chan, Jun Yu, Siew C. Ng, Nelson Lee, Justin C.Y. Wu, Joseph J.Y. Sung, William K.K. Wu
, and Sunny H. Wong
, and Sunny H. Wong
Table 5
Temporal change in exposure prevalence for patients with Clostridium difficile infections in association with trend in recurrence, Hong Kong, China, 2006–2014*
| Exposure | Period, prevalence (standardized Pearson residuals), % |
Absolute residual difference, %† | p value‡ | ||
|---|---|---|---|---|---|
| 2006–2008 | 2009–2011 | 2012–2014 | |||
| Age, y | |||||
| <44 | 18.3 (0.4) | 34.9 (3.0) | 46.8 (−2.5) | 2.9 | <0.01 |
| 45–64 | 17.4 (−0.6) | 32.5 (2.6) | 50.1 (−1.7) | 1.1 | <0.01 |
| 65–84 | 19.2 (2.7) | 28.9 (−1.4) | 51.9 (−0.5) | 3.2 | <0.01 |
| >85 | 16.1 (−3.0) | 28.4 (−1.8) | 55.5 (3.1) | 6.1 | <0.01 |
| Male sex | 48.6 (0.1) | 48.5 (0.0) | 48.4 (−0.1) | 0.2 | 0.97 |
| Resident of home for elderly persons | 27.6 (−2.6) | 29.5 (−1.0) | 31.6 (2.3) | 4.9 | <0.01 |
| Severe disease | 16.9 (10.5) | 32.6 (2.6) | 50.5 (−6.7) | 17.2 | <0.01 |
| Antimicrobial drug use§ | |||||
| High-risk drug | 18.5 (1.5) | 28.4 (−2.7) | 53.1 (1.2) | 0.3 | 0.65 |
| Medium-risk drug | 17.4 (−1.1) | 28.1 (−3.6) | 54.5 (3.3) | 4.4 | <0.01 |
| Low-risk drug | 12.6 (−1.9) | 19.3 (−2.9) | 152 (3.3) | 5.2 | <0.01 |
| Diagnostic test | |||||
| Bacterial culture | 18.9 (1.7) | 29.0 (−1.0) | 52.0 (−0.3) | 2 | <0.01 |
| Toxin detection | 36.0 (31.1) | 35.0 (6.9) | 28.9 (−23.4) | 54.5 | <0.01 |
| NAAT | 0 (−31.7) | 25.7 (−5.7) | 74.3 (22.9) | 54.6 | <0.01 |
| Use of proton-pump inhibitor | 35.8 (−9.0) | 40.7 (−6.6) | 55.2 (10.3) | 19.3 | <0.01 |
| Use of histamine-2 receptor antagonist | 54.7 (6.0) | 46.1 (−0.9) | 44.9 (−2.9) | 8.9 | <0.01 |
| Healthcare-associated disease | 18.1 (0.7) | 30.0 (0.5) | 51.9 (−0.7) | 1.4 | <0.01 |
| Concurrent condition | |||||
| Myocardial infarction | 5.3 (−7.2) | 7.9 (−3.4) | 11.7 (6.8) | 14 | <0.001 |
| Cerebrovascular disease accident | 28.8 (−3.4) | 32.8 (0.5) | 33.5 (1.7) | 5.1 | <0.01 |
| Chronic lung disease | 12.4 (−3.6) | 14.5 (−1.0) | 16.3 (2.9) | 6.5 | <0.01 |
| Diabetes mellitus | 20.5 (2.6) | 19.0 (1.0) | 17.3 (−2.3) | 4.9 | <0.01 |
| Renal disease | 18.4 (−4.8) | 22.5 (−0.2) | 24.3 (3.1) | 7.9 | <0.01 |
| Nonmetastatic tumor | 21.7 (−3.7) | 27.1 (2.6) | 25.2 (0.2) | 3.9 | 0.01 |
| AIDS | 0.5 (0.2) | 0.6 (0.8) | 0.4 (−0.7) | 0.9 | 0.55 |
| Inflammatory bowel disease | 0.5 (−2.0) | 0.7 (−1.2) | 1.1 (2.2) | 4.4 | 0.01 |
*NAAT, nucleic acid amplification test.
†Absolute difference between standardized Pearson residuals in 2012–2014 and 2006–2008.
‡By χ2 test for trend.
§Antimicrobial drug use 8 weeks before diagnosis was stratified into high risk (floroquinolones, cephalosporins, and clindamycin); medium risk (penicillins, macrolides, and sulfonamides); and low risk (tetracyclines).
1These authors contributed equally to this article.
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