Clostridium difficile Sentinel Surveillance, 2014
In 2009 the Minnesota Department of Health (MDH) Emerging Infections Program (EIP) began laboratory,
population-based active surveillance for Clostridium difficile Infection (CDI) in collaboration with the
Centers for Disease Control and Prevention (CDC). The surveillance includes all patients at least 1 year of age,
with positive Clostridium difficile tests who reside in Benton, Morrison, Olmsted (added in 2012) Stearns,
and Todd counties. Patients are categorized into three epidemiologic classifications depending on the location
and timing of the C. difficile positive sample in relation to healthcare exposure.
Epidemiologic Classification
Total C. difficile Infections (CDI)
Community Associated (CA)
developed CDI in the community and had
no overnight stay in a healthcare facility in the past 12 weeks.
200
Community Onset, Healthcare Facility Associated (CO-HCFA)
developed CDI in the community and had
an overnight stay in a healthcare facility in the past 12 weeks.
100
Healthcare Facility Onset (HCFO)
developed CDI in a healthcare facility
and had CDI specimen collected 4 days after admission.
150
20%
55%
25%
50
0
2009
• A healthcare facility is defined as an acute care hospital,
long-term acute care hospital, or long-term care facility.
2010
2011
2012
2013
2014
Number of Infections per 100,000 Population by Year* and Epidemiologic Classification
Prior Antibiotic Use (Risk Factors)
65+
49% of interviewed CA patients reported taking an
antibiotic# in the 12 weeks prior to their illness; of those:
- 31% for ear, sinus, or upper respiratory infections
- 14% skin infections
- 13% dental procedures
- 12% urinary tract infections
10%
20%
30%
40%
50%
60%
Infectious Disease Epidemiology, Prevention and Control
651-201-5414 or 1-877-676-5414
www.health.state.mn.us
10/8/2015
70%
80%
90%
100%
40%
41%
male
28%
18 - 44
59%
female
1 - 17
71% of all CDI patients received
antibiotics in the 12 weeks
prior to their illness
0%
4 of 10 people with CDI
are older than 65
6 of 10 people with CDI
are female
45 - 64
11% of interviewed CA patients reported no antibiotic and no healthcare exposure in the 12 weeks prior
to illness (as documented in medical record and reported on interview)
0%
50%
Infections by Sex
100%
0%
25%
7%
10%
20%
30%
Infections by Age
* Incidence rates, per 100,000 population, based on estimated 2013 population (ages >1 yr.) data for Benton, Morrison, Olmsted, Stearns, and Todd Counties
** One major clinical laboratory switched laboratory testing methods from EIA to PCR in 2010
#
May have taken >1 antibiotic or for >1 problem
Because C. difficile is reportable in only 5 counties, the results may not be generalizable to the entire state of Minnesota
40%
50%