C. difficile Disproportionately Affects Patients Across Demographic, Socioeconomic Lines
AT A GLANCE
- People considered highly vulnerable based on race and ethnicity were drastically more likely to face complications and death caused by Clostridioides difficile infections compared to less vulnerable people.
- Race and ethnicity, housing characteristics, socioeconomic status and housing and transportation all affect C. diff outcomes.
- Researchers suggest more data and resources are necessary to uncover the effect of health inequities demonstrated by the study.
People considered highly vulnerable based on demographic and socioeconomic factors are more likely to face complications from Clostridioides difficile infections compared to those considered less vulnerable, according to new findings presented at IDWeek 2024.
The study found that people with high vulnerability scores as measured by the U.S. Centers for Disease Control and Prevention’s Social Vulnerability Index for race/ethnicity were 37 times more likely to be diagnosed with C. diff and nine times more likely to die compared to those with low scores. Patients with high vulnerability scores in socioeconomic status and housing characteristics such as age, disability, English-speaking ability were three times more likely to have severe C. diff than those with low scores.
Patients with high vulnerability scores for housing and transportation – including those living in multiunit structures, mobile homes, group quarters, and lacking a vehicle – were more than twice as likely to contract C. diff compared to people with low scores.
Researchers included 206 adults admitted to Loma Linda University Medical Center with a case of C. diff from January 2020 to June 2021 in the study. The study used the SVI—which looks at socioeconomic status, household characteristics, race/ethnicity and housing and transportation as factors that affect health—to assess the effects of environmental factors on C. diff severity and mortality rate. People with an SVI score of less than 0.5 were considered low vulnerability in the study, while people above 0.5 were considered high vulnerability.
“We need to conduct further research to gain a deeper understanding of the correlations between C. diff severity and mortality, race and environmental and socioeconomic factors,” said Timothy Afable, PharmD, pharmacy resident at Loma Linda University and presenting author. “This study is only a starting point to a broader understanding of health equity and the potential vulnerabilities patients with C. diff face.”
In addition to Dr. Afable, study co-authors include: Jacinda C. Abdul-Mutakabbir, PharmD, MPH; Karen Tan, PharmD, BCIDP; and Anna Zhou, PharmD, BCIDP.
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