Link: Use Of Gastric
Recent press about hospital C Diff has not highlighted the facts below. They point to over a possible 12,000 community acquirred cases of C Diff per year in the UK. Its not clear how many of these are of the virulent strain now being found in hospitals.
A British study identified C difficile as the third most common cause of infectious diarrhea in patients aged 75 years and older seen by general practitioners. A French study performed in outpatients to whom antibiotics were prescribed reported an incidence of C difficile-associated disease (CDAD) of 1.5 percent and estimated that up to 920,000 outpatients nationwide could potentially develop toxinogenic CDAD yearly. Recent data suggest that both the rates and severity of nosocomial CDAD are increasing. While the rates of CDAD in the community are much lower than in the hospital setting, the absolute number of cases in the community could be significant.
Sandra Dial, M.D., M.Sc., and colleagues from McGill University, Montreal, conducted a study to determine whether the use of gastric acid-suppressant drugs is associated with the risk of community-acquired CDAD. This study consisted of two population-based case-control studies using the United Kingdom General Practice Research Database (GPRD). In the first study, the researchers identified all 1,672 cases of C difficile recorded between 1994 and 2004 among all patients registered for at least 2 years in each practice.
The researchers found that of these 1,672 patients, 1,233 (74 percent) had not been hospitalized in the year prior to diagnosis and were considered community-acquired. There has been a significant increase in the rate of C difficile cases diagnosed in the community from less than 1 per 100,000 persons in 1994 to 22 per 100,000 in 2004.
