APMAdvances in Precision Medicine2424-85922424-9106WHIOCE PUBLISHING PTE. LTD.10.18063/apm.v7i1.241ArticleThe Trend of Clostridioides difficile Infection in Korean  Hospitals with the Analysis of Nationwide Sample  Cohorthttps://artdesignp.com/journal/APM/7/1/10.18063/apm.v7i1.241SonKang Ju,KimYoung Ah,ParkYoon Soo2022712022-07-25Background: Clostridioides (Clostridium) difficile is an important  pathogen that causes diarrhea in people who take antibiotics. The recent  status of C. difficile infection is not well known in Korea. Methods: The long-term trend of C. difficile infection in Korean hospitals was  analyzed using a nationwide sample cohort. The data also included  sociodemographic characteristics, disease severity, and healthcare  facilities. C. difficile infection was defined by the prescription of  oral vancomycin or all metronidazole prescriptions under C. difficile infectious disease code (A047). Results: The rate of C. difficile infection has steadily increased from 0.030% in 2006 to 0.317% in  2015. The increased rate correlated to age (0.033% for < 50 years,  0.421% for 70–79 years, and 0.758% for > 80 years of age) and the  Charlson comorbidity index score (0.048% for zero versus 0.378%  for three or more points). It differed by the type of medical institution  (0.270% at referral hospitals versus 0.056 % at general hospitals and  mental hospitals). Conclusion: The rate of C. difficile infection in Korea  is significant in patients with advanced age and disease severity. The  results show that C. difficile infection trend has been increasing steadily  in Korea.Clostridioides difficile,Cohort studies,Infections,Rate,Trend

1. Bartlett JG. Clostridium difficile: History of Its Role as an Enteric Pathogen and the Current State of Knowledge About the Organism. Clin Infect Dis. 1994;18(Suppl 4):S265-S272.2. Pepin J, Valiquette L, Alary ME, et al. Clostridium difficile-Associated Diarrhea in a Region of Quebec from 1991 to 2003: A Changing Pattern of Disease Severity. Can Med Assoc J. 2004;171(5):466-472.3. Loo VG, Poirier L, Miller MA, et al. A Predominantly Clonal Multi-Institutional Outbreak of Clostridium difficile-Associated Diarrhea with High Morbidity and Mortality. N Engl J Med. 2005;353(23):2442-2449.4. Kim YS, Han DS, Kim YH, et al. Incidence and Clinical Features of Clostridium difficile Infection in Korea: A Nationwide Study. Epidemiol Infect. 2013;141(2):189-194.5. Choi HY, Park S, Kim Y, et al. The Epidemiology and Economic Burden of Clostridium difficile Infection in Korea. Biomed Res Int. 2015;2015:510386.6. Lee J, Lee JS, Park SH, et al. Cohort Profile: The National Health Insurance Service National Sample Cohort (NHIS-NSC), South Korea. Int J Epidemiol. 2017;46(1):e15.7. Kim KH. Comparative Study on Three Algorithms of the ICD-10 Charlson Comorbidity Index with Myocardial Infarction Patients. J Prev Med Public Health. 2010;43(1):42-49.8. Quan H, Li B, Couris CM, et al. Updating and Validating the Charlson Comorbidity Index and Score for Risk Adjustment in Hospital Discharge Abstracts using Data from 6 Countries. Am J Epidemiol. 2011;173(8):676-682.9. Martín-Loeches I, Díaz E, Vallés J. Risks for Multidrug-Resistant Pathogens in the ICU. Curr Opin Crit Care. 2014;20(4):516-524.10. Yoon YK, Park GC, An H, et al. Trends of Antibiotic Consumption in Korea According to National Reimbursement Data (2008-2012): A Population-Based Epidemiologic Study. Medicine. 2015;94(50):e2100.11. Kim D, Ahn JY, Lee CH, et al. Increasing Resistance to Extended Spectrum Cephalosporins, Fluoroquinolone, and Carbapenem in Gram-Negative Bacilli and the Emergence of Carbapenem Non-Susceptibility in Klebsiella pneumoniae: Analysis of Korean Antimicrobial Resistance Monitoring System (KARMS) Data from 2013 to 2015. Ann Lab Med. 2017;37(2):231-239.12. Lee H, Yoon EJ, Kim D, et al. Antimicrobial Resistance of Major Clinical Pathogens in South Korea, May 2016 to April 2017: First One-Year Report from Kor-GLASS. Euro Surveill. 2018;23(14):1800047.13. Centers for Disease Control and Prevention. Antibiotic resistance threats in the United States, 2019. Accessed December 4, 2020. https://www.cdc.gov/drugresistance/pdf/threats-report/2019-ar-threats-report-508.pdf14. Byun JH, Kim H, Kim JL, et al. A Nationwide Study of Molecular Epidemiology and Antimicrobial Susceptibility of Clostridioides difficile in South Korea. Anaerobe. 2019;60:102106.15. Nicholas A, Kim YK, Lee WK, et al. Molecular Epidemiology and Antimicrobial Susceptibility of Clostridium difficile Isolates from Two Korean Hospitals. PLoS One. 2017;12(2):e0174716.16. Friedman ND, Kaye KS, Stout JE, et al. Health Care-Associated Bloodstream Infections in Adults: A Reason to Change the Accepted Definition of Community-Acquired Infections. Ann Intern Med. 2002;137(10):791-797.