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Clostridium difficile Infection Tracking

C. difficile infections are a leading cause of patient harm in the U.S. medical system. Data from this project will help inform future policy and prevention strategies to reduce C. difficile disease.

Specifically, the EIP C. difficile surveillance project will:

  • Determine the burden of C. difficile disease in the United States
  • Identify proportion of infections associated with medical care
  • Measure trends of disease over time
  • Determine which strains of C. difficile are causing disease, and in what proportions

In addition, the project provides infrastructure for further research including studies to identify risk factors, to determine population targets for vaccines, and to monitor the efficacy of prevention strategies.

Technical information about this project can be found at "Technical Information — Measuring the Scope of Clostridium difficile Infection in the United States."


Response to Inaccuracies in Clostridium difficile Infection (CDI) EIP Surveillance Data Reported from Oregon in 2010

On June 1, 2015, the Department of Health and Human Services, Office of Research Integrity (ORI) issued a Notice of Findings of Research Misconduct in the Federal Register related to research activities conducted at the Oregon Health Authority, Public Health Division and supported by the Centers for Disease Control and Prevention (CDC) Emerging Infections Program Grant 5U01CI00306-05 [Available here]. Specifically, the research misconduct reported in the Notice related to Clostridium difficile (C. diff, or CDI) surveillance data collected by the Oregon Emerging Infections Program (EIP) during 2010-2011. This situation involved a staff person falsifying and/or fabricating 56 CDI case report forms. As a result of this research misconduct, inaccurate clinical data were included in one published report in CDC’s Morbidity and Mortality Weekly Reports (MMWR) from March 6, 2012 entitled, Vital Signs: Preventing Clostridium difficile Infections, multiple internal CDC presentations in 2012, and in an abstract presented to the 11th Biennial Congress of the Anaerobe Society entitled Community-Associated Clostridium difficile: How Real Is It? [PDF - 246 pages]. In addition, inaccurate clinical data were included in an abstract presented at IDWeek 2012 entitled Evaluation of Differences in Population-Based Incidence of Clostridium difficile Infection across Diverse U.S. Geographic Locations, 2010. As reported by ORI, the inaccurate Oregon CDI data were also initially included in a manuscript submitted to JAMA Internal Medicine in January 2013; however, Oregon CDI data were removed from the manuscript during the revision process and prior to the manuscript being accepted by the journal for publication. The published manuscript, released on June 17, 2013, does not contain Oregon CDI data. An assessment has been made of inaccuracies introduced to the MMWR report and above-mentioned abstracts. Oregon CDI cases constituted 0.6% of the 10,342 cases reported from eight EIP sites in 2010 and included in the MMWR report. Based upon a reanalysis excluding all Oregon CDI cases, the impact on the MMWR report results was minimal, and there was no change in the scientific conclusions. All subsequent analyses of CDI data have been performed on a corrected dataset.


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