A new CDC report, published in the New England Journal of Medicine, shows Clostridioides difficile (C. diff) infection (CDI) and associated hospitalizations in the United States decreased during 2011-2017.


The report, Trends in U.S. Burden of Clostridioides difficile Infection and Outcomes, shows that total cases of CDI decreased 24% after adjusting the data for the use of a more sensitive type of test called nucleic acid amplification tests (NAAT). This overall decrease was driven by a 36% decrease in healthcare-associated cases (those that happen in a healthcare facility or associated with recent admission to a healthcare facility), while community-associated CDI (those that happen in the community, outside of healthcare facilities) did not change. After adjusting for NAAT use, hospitalizations as a result of CDI also decreased by 24%. There were no changes in the estimates of first recurrences (people who get C. diff again within 2-8 weeks after their first infection) and in-hospital deaths.

Preventing C. diff infections is a national priority. Efforts to improve infection prevention and antibiotic and diagnostic stewardship continue to expand across healthcare settings, particularly in hospitals. Enhanced prevention strategies that target healthcare- and community-associated CDI may further reduce the overall infection rate. Improving outpatient antibiotic use can also help reduce antibiotic-associated adverse events like CDI and improve patient safety.