Racial and ethnic disparities in health care–associated Clostridium difficile infections in the United States: State of the science

• We performed a literature review on the association between race/ethnicity and CDI.
• There are significant gaps and limitations in the existing literature.
• There is limited evidence that certain racial groups are at greater risk for CDI.
• Key recommendations are provided for future research.

BackgroundAmong health care-associated infections (HAIs), Clostridium difficile infections (CDIs) are a major cause of morbidity and mortality in the United States. As national progress toward CDI prevention continues, it will be critical to ensure that the benefits from CDI prevention are realized across different patient demographic groups, including any targeted interventions.MethodsThrough a comprehensive review of existing evidence for racial/ethnic and other disparities in CDIs, we identified a few general trends, but the results were heterogeneous and highlight significant gaps in the literature.ResultsThe majority of analyzed studies identified white patients as at increased risk of CDIs, although there is a very limited literature base, and many studies had significant methodological limitations.ConclusionKey recommendations for future research are provided to address antimicrobial stewardship programs and populations that may be at increased risk for CDIs.