- Although absolute risk is low vs other risk factors, sharing a household with a family member who has a Clostridioides difficile infection (CDI) appears to increase likelihood of transmission/acquisition.
Why this matters
- Educate patients with confirmed CDI about risk for other household members, including need for testing following diarrhea exposure and the importance of effectively cleaning shared bathrooms.
- 224,818 cases; 194,424 enrollees.
- 40.1% (90,212) hospital-onset; 1074 cases (1050 people) followed prior to CDI event in a household member.
- On stratified regression across all cases, increased CDI risk (incident rate ratios [IRRs]; 95% CIs) seen with:
- Prior hospital exposure: 16.18 (15.31-17.10).
- Family exposure: 12.47 (8.86-16.97).
- Age ≥65 years: 9.90 (8.93-10.98).
- Female sex: 1.44 (1.36-1.53).
- Community-onset CDI alone: IRR, 16.00 (95% CI, 11.72-21.22).
- Community-onset CDI without prior hospitalization: IRR, 21.74 (95% CI, 15.12-30.01).
- Family exposure with prior hospitalization was associated with significantly greater incidence of hospital-onset CDI: IRR, 6.73 (95% CI, 3.30-12.00).
- Prior family CDI exposure in ages 18-26 years was nonsignificant.
- Case-control study assessing incidence of potential CDI household transmission based on longitudinal insurance claims (CDI incidence in monthly enrollment stratum).
- Funding: CDC.
- Bias toward the null.
- Missing confounders.