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Infection Control in Healthcare · Journal article
Military Medicine · August 4, 2026
Reinforces what was already believed, rather than introducing something new.
This retrospective cohort study of 2.7 million active-duty service members identified 2,489 CDI cases over 2016–2024, yielding an incidence of 21.4 per 100,000 person-years with a 43.5% decline in annual cases over the observation window. Women and older service members bore higher risk, and gastrointestinal comorbidities were more common in cases, supporting targeted prevention and post-CDI follow-up strategies.
Retrospective cohort study. Active-duty service members enrolled in MARS from January 2016 to December 2024; younger population with frequent travel, antibiotic exposure, and close living conditions; no explicit exclusion criteria stated.. n = 2,700,000. U.S. Military (service branches: Army, Air Force, and others).
Overall CDI incidence was 21.4 per 100,000 person-years; annual infections declined from 324 in 2016 to 183 in 2024 (43.5% decline) Women had higher risk than men (RR 1.7; 95% CI 1.6–1.9) Service members aged 50 had highest risk (RR 6.0; 95% CI 4.6–7.9)
No data on CDI recurrence rates, complications, or mortality Treatment patterns described but not compared to guidelines or outcomes; no efficacy or mortality by therapy
Clinicians managing military personnel should recognize that CDI risk is higher in women and older service members, and that gastrointestinal comorbidities predict both incident and recurrent CDI. The declining annual incidence suggests successful prevention measures, but structured post-CDI care pathways remain warranted, particularly for high-risk groups.
A large retrospective cohort study of 2.7 million service members over 9 years confirming known CDI epidemiology and risk factors in a distinctive military population, with clear descriptive findings but no intervention comparison or hard clinical outcomes.
As stated by the source record.
Quoted from the source exactly as published.
Clinicians managing military personnel should recognize that CDI risk is higher in women and older service members, and that gastrointestinal comorbidities predict both incident and recurrent CDI. The declining annual incidence suggests successful prevention measures, but structured post-CDI care pathways remain warranted, particularly for high-risk groups.
Graded across the dimensions that decide whether you should act, each from what the source actually supports. There is no single score, and where a dimension was not assessed it says so.
Abstract Background Clostridioides difficile (C. difficile) is ubiquitous and remains a public health concern with substantial morbidity and economic burden. Active-duty service members (ADSMs) are a distinctive population given their younger age, frequent travel, antibiotic exposure, and close living conditions. This study updates the epidemiology of C. difficile infection (CDI) in ADSMs from 2016 to 2024. Materials and Methods This retrospective analysis utilized data from 2.7 million ADSMs between January 2016 and December 2024 from the Medical Assessment and Readiness System. CDI was identified using ICD-10 codes. We extracted associated sociodemographic, occupational, and clinical variables, including age, sex, race/ethnicity, BMI, selected comorbidities, CDI treatment, and gastrointestinal diagnoses. Results A total of 2,489 CDI cases were identified, with an overall incidence rate of 21.4 per 100,000 person-years. Total annual infections declined from 324 in 2016 to 183 in 2024. Cases were concentrated in the Army (41.5%) and Air Force (28.0%). Women had a higher risk than men (risk ratio [RR], 1.7; 95% CI, 1.6-1.9). Risk increased with age, with ADSMs aged 50 at the highest risk (RR, 6.0; 95% CI, 4.6-7.9). Vancomycin was the most frequently recorded therapy, with lower use of metronidazole and fidaxomicin. Conclusions In a large military cohort, CDI incidence was modest yet clinically relevant, with higher risk among women and heterogeneity across service branches. Compared with prior research, the overall incidence of CDI among ADSMs has increased, but over this observation window, the annual CDI incidence has declined by 43.5%. Gastrointestinal diagnoses, including irritable bowel syndrome and inflammatory bowel disease, were more frequently recorded among service members with CDI, including during follow-up after the index diagnosis. Findings support targeted prevention and follow-up, including outpatient antimicrobial stewardship and structured post-CDI care pathways.
Taken from the source record, never inferred. Follow any of these and new work involving them reaches your briefing.