CA-MRSA in Outpatients, United States, 1999–2006, CME Activity | CDC EID

EID Journal Home > Volume 16, Number 2–February 2010

Volume 16, Number 2–February 2010
CME ACTIVITY
Risk Factors for and Estimated Incidence of Community-associated Clostridium difficile Infection, North Carolina, USA

MedscapeCME is pleased to provide online continuing medical education (CME) for this journal article, allowing clinicians the opportunity to earn CME credit. This activity has been planned and implemented in accordance with the Essential Areas and policies of the Accreditation Council for Continuing Medical Education through the joint sponsorship of MedscapeCME and Emerging Infectious Diseases. MedscapeCME is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians. MedscapeCME designates this educational activity for a maximum of 0.75 AMA PRA Category 1 Credits™. Physicians should only claim credit commensurate with the extent of their participation in the activity. All other clinicians completing this activity will be issued a certificate of participation. To participate in this journal CME activity: (1) review the learning objectives and author disclosures; (2) study the education content; (3) take the post-test and/or complete the evaluation at http://www.medscape.com/cme/eid; (4) view/print certificate.

Learning Objectives
Upon completion of this activity, participants will be able to:

Specify the prevalence of community-acquired Clostridium difficile infection
Describe demographic trends in community-acquired C. difficile infection
Identify case characteristics of C. difficile infection
List risk factors for community-acquired C. difficile infection
CME Editor
Nancy Mannikko, PhD, MS, BS, Copyeditor, Emerging Infectious Diseases. Disclosure: Nancy Mannikko, PhD, MS, BS, has disclosed no relevant financial relationships.

CME Author
Charles P. Vega, MD, Associate Professor, Residency Director, Department of Family Medicine, University of California, Irvine, California, USA. Disclosure: Charles P. Vega, MD, has disclosed no relevant financial relationships.

Authors
Disclosures: Preeta K. Kutty, MD, MPH; Arlene C. Sena, MD, MPH; Stephen R. Benoit, MD, MPH; Susanna Naggie, MD; Joyce Frederick, MSN; Sharon Evans, RN; Jeffery Engel, MD; and L. Clifford McDonald, MD, have disclosed no relevant financial relationships. Christopher W. Woods, MD, MPH, has disclosed the following relevant financial relationships: served as an advisor or consultant for Cepheid Diagnostics, Roche Molecular, and bioMérieux; received grants for clinical research from Cepheid Diagnostics, Roche Molecular, bioMérieux, Cubist Pharmaceuticals, and Theravance Pharmaceuticals.

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EID Journal Home > Volume 16, Number 2–February 2010

Volume 16, Number 2–February 2010
Research
Risk Factors for and Estimated Incidence of Community-associated Clostridium difficile Infection, North Carolina, USA1
Preeta K. Kutty, Christopher W. Woods, Arlene C. Sena, Stephen R. Benoit, Susanna Naggie, Joyce Frederick, Sharon Evans, Jeffery Engel, and L. Clifford McDonald
Author affiliations: Centers for Disease Control and Prevention, Atlanta, Georgia, USA (P.K. Kutty, S.R. Benoit, L.C. McDonald); Department of Veterans Affairs Medical Center, Durham, North Carolina, USA (C.W. Woods, S. Naggie, J. Frederick); Duke University Medical Center, Durham (C.W. Woods, S. Naggie, S. Evans); Durham County Health Department, Durham (A.C. Sena); University of North Carolina, Chapel Hill, North Carolina, USA (A.C. Sena); and North Carolina Department of Health and Human Services, Raleigh, North Carolina, USA (J. Engel)

Suggested citation for this article

Abstract
We determined estimated incidence of and risk factors for community-associated Clostridium difficile infection (CA-CDI) among patients treated at 6 North Carolina hospitals. CA-CDI case-patients were defined as adults (>18 years of age) with a positive stool test result for C. difficile toxin and no hospitalization within the prior 8 weeks. CA-CDI incidence was 21 and 46 per 100,000 person-years in Veterans Affairs (VA) outpatients and Durham County populations, respectively. VA case-patients were more likely than controls to have received antimicrobial drugs (adjusted odds ratio [aOR] 17.8, 95% confidence interval [CI] 6.6–48] and to have had a recent outpatient visit (aOR 5.1, 95% CI 1.5–17.9). County case-patients were more likely than controls to have received antimicrobial drugs (aOR 9.1, 95% CI 2.9–28.9), to have gastroesophageal reflux disease (aOR 11.2, 95% CI 1.9–64.2), and to have cardiac failure (aOR 3.8, 95% CI 1.1–13.7). Risk factors for CA-CDI overlap with those for healthcare-associated infection.