C. Diff Infection: An Urgent Public Health Threat

C. Diff Infection

An Urgent Public Health Threat

A major and urgent threat, according to the US Centers for Disease Control and Prevention (CDC), C. diff infection is one of the most common health care-associated infections in US hospitals, affecting approximately half a million people annually.1,2

Significant complications
associated with C. diff infection



aFirst recurrence.



aFirst recurrence.

Heart Failure



up to60%5







Mortality associated with C. diff infection:

30-day mortality rate of C. diff infection ranges from 5% to 14% after an initial episode.2,7

A study of Medicare patients with community-acquired C. diff infection documented a 9% mortality rate during inpatient stay.8

In a recent CDC reseach letter, patients (N=9) with severe-acute-respiratory syndrome coronavirus 2 (COVID-19) and C. diff infection had a 44% mortality rate.9

Unfortunately, C. diff infection may be the beginning of a vicious cycle of recurrence.


  1. Centers for Disease Control and Prevention. Clostridioides Difficile: https://www.cdc.gov/drugresistance/pdf/threats-report/clostridioides-difficile-508.pdf. Accessed March 31, 2021.
  2. Lessa FC, Mu Y, Bamberg WM, et al. Burden of Clostridium difficile infection in the United States. N Engl J Med. 2015;372(9):825-834.
  3. Feuerstadt P, Boules M, Stong L, et al. Clinical complications in patients with primary and recurrent Clostridioides difficile infection: a real-world data analysis. Published January 14, 2021. SAGE Open Med. 2021;9:2050312120986733. doi:10.1177/2050312120986733
  4. Nelson WW, Scott TA, Boules M, et al. Health care utilization and costs of recurrent Clostridioides difficile infection in the elderly: a real-world claim analysis [published online March 11, 2021]. J Manag Care Spec Pharm. 2021;1-11. doi:10.18553/jmcp.2021.20395
  5. Leong C, Zelenitsky S. Treatment strategies for recurrent Clostridium difficile infection. Can J Hosp Pharm. 2013;66(6):361-368.
  6. Scott TA, Unni S, Boules M, et al. Clinical burden of recurrent Clostridioides difficile infection in the Medicare population. Presented at: 2020 Digestive Disease Week; May 2-5, 2020; Chicago, IL.
  7. Freeman J, Bauer MP, Baines SD, et al. The changing epidemiology of Clostridium difficile infections. Clin Microbiol Rev. 2010;23(3):529-549.
  8. Collins CE, Ayturk MD, Flahive JM, et al. Epidemiology and outcomes of community-acquired Clostridium difficile infections in medicare beneficiaries. J Am Coll Surg. 2014;218(6):1141-1147.e1.
  9. Sandhu A, Tillotson G, Polistico J, et al. Clostridioides difficile in COVID-19 patients, Detroit, Michigan, USA, March–April 2020. Emerg Infect Dis. 2020;26(9).2272-2274.