Environmental Indicators for Clostridium Difficile

J.S. Jagai, A.A Kosheleva, D.A. Castronovo, E.N. Naumova

Background

• The incidence of Clostridium difficile associated diarrhea has risen over the past two decades
  
• In the US more than 300,000 cases per year occur in hospitals or long-term care facilities.
  
• 75% of cases of antibiotic associated diarrhea are attributable to C. difficile.

Objective

• To determine if the rates of C. difficile are associated with meteorological characteristics in different climate zones.

Methods

• Abstracted hospitalization records for C. difficile, infections and symptoms from 1998-2002.
  
• Calculated annual rates for each county (3108).
  
• Classified each county based on the Koppen Climate classification scheme and assigned to a watershed region.
  
• Compared the rates across climate categories and watersheds using ANOVA.

Results and Conclusions

• Average annual county-specific hospitalization rate of C. difficile per 100,000 elderly was 234.59 ± 160.40 cases.
  
• The highest rates were seen in the humid climate region of the Midwest (301.75 ± 182.34) and the Ohio Region watershed (355.48 ± 167.94).
  
• Preliminary results suggest that higher rates of C. difficile are associated with climate-sensitive environmental characteristics.