Background Clostridioides difficile infection (CDI) is a leading cause of hospital-acquired infection associated with significant morbidity, mortality and healthcare costs. Comparisons of disease burden between countries are complicated by heterogeneity in diagnostic testing and surveillance practices. Aims To quantify CDI-related hospitalisations in Ireland between 2009 and 2022 and to examine temporal trends in patient demographics, length of stay (LOS), admission type, and in-hospital mortality. Methods We conducted a retrospective analysis of the national Hospital Inpatient Enquiry (HIPE) database, including all discharges from Irish public hospitals coded with CDI (ICD-10-AM A04.7) between 2009 and 2022. Temporal trends were examined, and multivariable logistic regression was conducted using SPSS (v30) to identify factors independently associated with in-hospital mortality. Results Between 2009 and 2022, 20,956 CDI-related hospitalisations were recorded, accounting for approximately 0.2% of all hospitalisations in Ireland. Annual CDI-related hospitalisations increased by 66%, from 1,301 in 2009 to 1,962 in 2022. Over the same period, in-hospital mortality declined from 21.0% to 11.8%, and mean LOS decreased from 44.0 to 31.5 days. Logistic regression adjusting for age, sex, LOS, admission type, and year of hospitalisation, found the odds of in-hospital mortality were approximately 45% lower in 2022 versus 2009. Increasing age was the strongest independent predictor of mortality; patients aged ≥ 85 years had 72-fold higher odds of mortality compared with the youngest age group. CDI was recorded as the primary diagnosis in 28% of hospitalisations and was associated with lower mortality (adjusted OR 0.36, p < 0.001). Male sex (adjusted OR 1.26, p < 0.001) and elective admission (adjusted OR 1.31, p < 0.001) were independently associated with higher mortality. Conclusions CDI-related hospitalisations in Ireland increased substantially between 2009 and 2022, while in-hospital mortality rates and LOS declined. Despite these improvements, CDI is still associated with significant mortality among the elderly. Further research should examine the impact of acute hospital bed availability, faecal microbial transplant (FMT) access, and recurrent infections on CDI case rates.

Trends in Clostridioides Difficile Hospitalisations in Ireland (2009–2022)

期刊论文
发表日期：

2026年4月11日

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Ciaran Mc Closkey,
Ali AA El-Hakeem,
Mohammed EM Gafar,
Eoin Slattery

摘要

Background

Clostridioides difficile infection (CDI) is a leading cause of hospital-acquired infection associated with significant morbidity, mortality and healthcare costs. Comparisons of disease burden between countries are complicated by heterogeneity in diagnostic testing and surveillance practices.

Aims

To quantify CDI-related hospitalisations in Ireland between 2009 and 2022 and to examine temporal trends in patient demographics, length of stay (LOS), admission type, and in-hospital mortality.

Methods

We conducted a retrospective analysis of the national Hospital Inpatient Enquiry (HIPE) database, including all discharges from Irish public hospitals coded with CDI (ICD-10-AM A04.7) between 2009 and 2022. Temporal trends were examined, and multivariable logistic regression was conducted using SPSS (v30) to identify factors independently associated with in-hospital mortality.

Results

Between 2009 and 2022, 20,956 CDI-related hospitalisations were recorded, accounting for approximately 0.2% of all hospitalisations in Ireland. Annual CDI-related hospitalisations increased by 66%, from 1,301 in 2009 to 1,962 in 2022. Over the same period, in-hospital mortality declined from 21.0% to 11.8%, and mean LOS decreased from 44.0 to 31.5 days.

Logistic regression adjusting for age, sex, LOS, admission type, and year of hospitalisation, found the odds of in-hospital mortality were approximately 45% lower in 2022 versus 2009. Increasing age was the strongest independent predictor of mortality; patients aged ≥ 85 years had 72-fold higher odds of mortality compared with the youngest age group. CDI was recorded as the primary diagnosis in 28% of hospitalisations and was associated with lower mortality (adjusted OR 0.36, p < 0.001). Male sex (adjusted OR 1.26, p < 0.001) and elective admission (adjusted OR 1.31, p < 0.001) were independently associated with higher mortality.

Conclusions

CDI-related hospitalisations in Ireland increased substantially between 2009 and 2022, while in-hospital mortality rates and LOS declined. Despite these improvements, CDI is still associated with significant mortality among the elderly. Further research should examine the impact of acute hospital bed availability, faecal microbial transplant (FMT) access, and recurrent infections on CDI case rates.