Infectious Disease

Decrease socioeconomic standing related to community-based C. difficile

February 17, 2021

2 min read

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Skrobarcek does not report any relevant financial information. In the study you will find all relevant financial information from all other authors.

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Communities with a lower socioeconomic status have a higher incidence of community-based Clostridioides difficile infections, according to study results published in Clinical Infectious Diseases.

In the largest analysis to date, which researchers identified as the association between the socio-economic status of communities (SES) and the prevalence of community CDI (CA-CDI), the association was “specific [present in] Neighborhoods with low-income households or publicly funded income or residents below the poverty line who are unemployed or have public health insurance. In addition, communities with people who were overseas-born or who speak less English at home, or who have a crowded home at home have a higher incidence of CA-CDI. “

Kimberly Strength

“In recent years, CDI has been increasingly reported in the community in healthier populations previously considered low risk.” Kimberly Strength, MD, A medical worker with CDC’s global migration and quarantine division told Healio. “Up to 20% of people diagnosed with CA-CDI have no history of antibiotic or ambulatory health care exposures that are traditional risk factors for CDI.”

“Additionally,” Skrobarcek said, “while SES is widely recognized as having an important role in the acquisition and outcome of many infectious diseases, there is limited data on the SES factors that influence the development and spread of CDI in the community could influence. ” Therefore, we performed this analysis to identify community-level SES variables that are associated with CA-CDI incidence. “

Skrobarcek and colleagues evaluated the data from the CDC’s New Infection Program, which is conducting CDI surveillance in 35 counties in 10 states. According to the study, 9,682 CA-CDI cases were identified in these areas in the period 2014-2015, of which 9,413 (97.2%) were included in the analysis.

According to the study, one analysis identified “a three-factor model that accounted for 95% of the observed variance”. They labeled the SES variables “poverty”, “foreign born” and “high income”.

Using a multivariate analysis, Skrobaracek and colleagues found that “poverty” (RR = 1.19; 95% CI, 1.15-1.22) and “born abroad” (RR = 1.05; CI, 1, 02-1.08) were significantly associated with a high CA-CDI incidence, while “high income” was significantly associated with a low CA-CDI incidence (RR = 0.95; CI, 0.92-0.97) .

According to Skrobarcek, there are many different components of SES that could lead to an increased risk of CA-CDI.

“We believe that living in an impoverished community could be a substitute for the type of ambulatory healthcare exposure that increases the risk of developing CA-CDI,” she said, adding that people who are uninsured or not Are underinsured, may visit more often EDs are at high health care risk or the crowd in the home can increase risk of developing CDI, and foreign-born populations and those who speak less English at home may have it lack of resources for health education in their preferred language leading to an insufficient understanding of the risks associated with antibiotic use.

“This was just the first step in identifying the types of communities where CA-CDI is emerging,” Skrobarcek said. “Future studies are needed to determine whether this association is due to the effects of an impoverished person, a person living in an impoverished area, or a combination of both effects. Understanding the mechanisms by which SES factors influence CA-CDI incidence could help guide prevention efforts in these higher-risk areas. “

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