New Analysis Reveals Racial and Other Demographic Differences in C. diff Deaths Over 25 Years

At a Glance

• Deaths from infections due to the bacterium C. diff are more common among White people, women and those in large metropolitan areas, according to a new analysis of 25 years’ worth of data.
• Most C. diff deaths occur in inpatient and other health care settings, such as outpatient/emergency rooms and nursing or long-term care facilities.
• C. diff death rates peaked between 2006 and 2015; updated guidelines and preventive measures have since lowered rates.

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Clostridioides difficile infection is more likely to kill White people than African Americans/Black people or Hispanic people, according to new findings presented at IDWeek 2025. 

White people accounted for 83.9% of C. diff-related deaths, while African Americans/Black people made up 8.1%, and Hispanic people accounted for 5.5%, according to a review of 216,311 deaths due to C. diff in the United States between 1999 and 2023. C. diff death rates were higher for women than men, with women accounting for nearly three-fifths (58.2%) of deaths.

The study also revealed stark geographical differences in deaths caused by C. diff infection. More than eight-in-10 (83.8%) deaths occurred in and around big cities across the country, the research revealed. 

C. diff deaths peaked in the United States between 2006 and 2015, driven by emerging antibiotic-resistant pathogens, according to researchers. Data show that people in health care settings were especially susceptible: 71.2% of deaths occurred in inpatient settings, with another 21.2% in a nursing or long-term care facility, outpatient/emergency room setting or hospice facility. However, the overall C. diff death rate has fallen since 2015, driven in part by updated guidelines to prevent transmission, study authors say.

“C. diff’s prevalence in health care settings flips the usual dynamics of privilege: Those who can afford more access to health care are more likely to die from infection,” said Muhammad Sohaib Asghar, MBBS, MD, resident physician at AdventHealth Sebring and presenting author. “The United States must double down on progress made in lowering C. diff-related deaths by promoting responsible antibiotic use — particularly in health care settings — to address disparities.”

Experts recommend continuing to raise awareness of preventive measures like hand hygiene, improving antibiotic stewardship and conducting additional research to further reduce the burden of C. diff infection.

Researchers used demographic data from the U.S. Centers for Disease Control and Prevention WONDER database. The C. diff bacterium causes inflammation of the colon and can lead to nausea, diarrhea, abdominal pain, fever and death. 

In addition to Dr. Asghar, study co-authors include Rupesh Andani, MBBS, MD; Maria Duharte, BS; Afsana Ansari Shaik, MBBS, MD; Shehar Bano, MBBS, MD; and Luis Duharte-Vidaurre, MD.

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