The Epidemiology and Economic Burden ofClostridium difficileInfection in Korea

Abstract

The prevalence of Clostridium difficile infection and the associated burden have recently increased in many countries. While the main risk factors for C. difficile infection include old age and antibiotic use, the prevalence of this infection is increasing in low-risk groups. These trends highlight the need for research on C. difficile infection. This study pointed out the prevalence and economic burden of C. difficile infection and uses the representative national data which is primarily from the database of the Korean Health Insurance Review and Assessment Service, for 2008–2011. The annual economic cost was measured using a prevalence approach, which sums the costs incurred to treat C. difficile infection. C. difficile infection prevalence was estimated to have increased from 1.43 per 100,000 in 2008 to 5.06 per 100,000 in 2011. Moreover, mortality increased from 69 cases in 2008 to 172 in 2011. The economic cost increased concurrently, from $2.4 million in 2008 to $7.6 million, $10.5 million, and $15.8 million in 2009, 2010, and 2011, respectively. The increasing economic burden of C. difficile infection over the course of the study period emphasizes the need for intervention to minimize the burden of a preventable illness like C. difficile infection.

The incidence and drug resistance of Clostridium difficile infection in Mainland China: a systematic review and meta-analysis

“…Meanwhile, regarding the annual number of CDI patients at all of the hospitals that participated in this survey, the largest group of hospitals reported treating “1 to 5 patients a year,” representing 17.8% of the sample, and the second largest group of hospitals reported treated “no patients a year,” representing 13.1%32. In addition, the CDI incidence in Korea was estimated to be 5.06 per 100,000 population in 2011, whereas the estimated incidence in America per 100,000 population ranged from 30 to 120 cases of community-associated infection and from 50 to 160 cases of health care-associated infection across the Emerging Infections Program (EIP) sites in the same year3334. In Mainland China, the positive rate of toxigenic C. difficile infection in some provinces, such as Ningxia and Henan, was close to zero.…”

Distribution and risk factor analysis for Clostridium difficile‐associated diarrhea among hospitalized children over one year of age

“…According to the results reported by Zilberberg et al, 5 in 3739 hospitals in the United States, the CDAD frequency among hospitalized children increased from 7.24/10 000 in 1997 to 12.80/10 000 in 2006, with an annual rate of increase of 9%. The number of CDAD cases in Korean children increased from 30 in 2008 to 96 in 2011, equivalent to an increase from 0.5/100 000 to 1.7/100 000 13 . Recent epidemiological studies of CDAD in Shanghai and Guangzhou in China reported only a few scattered cases.…”

Detection and characterization of Clostridium difficile infections tracking the trends of Clostridium difficile culture

“…In addition, according to a study using the claims data of Health Insurance Review and Assessment Service, a total of 700 CDI patients in 2008, and 2521 CDI patients in 2011 were identified [10]. Although there are only a handful of data on the epidemiology of CDI, using only the claims data to estimate CDI incidence seems to be underestimating.…”

“…Also, according to a study including patient data from 17 hospitals, the incidence of CDI rose with statistical significance from 1.7 cases per 1,000 adult inpatients in 2004 to 2.7 cases in 2008 [9]. Furthermore, the number of deaths due to CDI also rose from 69 in 2008 to 172 in 2011 [10]. In addition, 37.5% of the 200 CDI patients were in a severe condition [11].…”

“…The economic burden due to C. difficile is also continuously increasing, from 7.6 million dollars in 2009 to 10.5 million dollars in 2010 and 15.8 million dollars in 2011 [10].…”