C. difficile Deaths Higher in Whites, Urban Areas

New research presented at IDWeek 2025 revealed that deaths from Clostridioides difficile infection (CDI) are significantly more common among White Americans and people living in large urban areas. Between 1999 and 2023, 83.9% of the 216,311 CDI-related deaths in the United States occurred in White individuals, compared with 8.1% in Black and 5.5% in Hispanic populations—despite their smaller share of the population. Researchers found that 83.8% of deaths were in metropolitan regions, and over 70% happened in hospital inpatients.

Lead author Dr. Muhammad Asghar noted that this pattern was unexpected since most healthcare-associated infections typically affect minorities with limited access to care. He suggested that higher antibiotic use and healthcare exposure among White populations might explain the difference. Women accounted for more CDI deaths than men (58.2% vs. 41.9%), and the South had the highest regional mortality. Death rates sharply rose between 2006 and 2015 due to hypervirulent C. difficile strains and treatment resistance but have since declined, thanks to new therapies like fidaxomicin and fecal microbiota transplantation, as well as stronger infection control and antibiotic stewardship efforts. The study highlights the ongoing need for preventive strategies to curb CDI-related deaths.