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Multicenter Study of Clostridium difficile Infection Rates from 2000 to 2006

Published online by Cambridge University Press:  02 January 2015

Erik R. Dubberke ,
Anne M. Butler ,
Deborah S. Yokoe ,
Jeanmarie Mayer ,
Bala Hota ,
Julie E. Mangino ,
Yosef M. Khan ,
Kyle J. Popovich ,
Victoria J. Fraser  and
Prevention Epicenters Program from the Centers for Disease Control and Prevention
Erik R. Dubberke*
Affiliation:
Department of Medicine, Washington University School of Medicine, St Louis, Missouri
Anne M. Butler
Affiliation:
Department of Medicine, Washington University School of Medicine, St Louis, Missouri
Deborah S. Yokoe
Affiliation:
Department of Medicine, Brigham and Women's Hospital, and Harvard Medical School, Boston, Massachusetts
Jeanmarie Mayer
Affiliation:
Department of Medicine, University of Utah Hospital, Salt Lake City, Utah
Bala Hota
Affiliation:
Department of Medicine, John H. Stroger Jr. Hospital of Cook County andRush University Medical Center, Chicago, Illinois
Julie E. Mangino
Affiliation:
Department of Medicine, The Ohio State University Medical Center, Columbus, Ohio
Yosef M. Khan
Affiliation:
Department of Medicine, The Ohio State University Medical Center, Columbus, Ohio
Victoria J. Fraser
Affiliation:
Department of Medicine, Washington University School of Medicine, St Louis, Missouri
*
Department of Medicine, Washington University School of Medicine, Box 8051, 660 South Euclid, St Louis, MO 63110, (edubberk@im.wustl.edu)
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Extract

Objective.

To compare incidence rates of Clostridium difficile infection (CDI) during a 6-year period among 5 geographically diverse academic medical centers across the United States by use of recommended standardized surveillance definitions of CDI that incorporate recent information on healthcare facility (HCF) exposure.

Methods.

Data on C. difficile toxin assay results and dates of hospital admission and discharge were collected from electronic databases. Chart review was performed for patients with a positive C. difficile toxin assay result who were identified within 48 hours after hospital admission to determine whether they had any HCF exposure during the 90 days prior to their hospital admission. CDI cases, defined as any inpatient with a stool toxin assay positive for C. difficile, were categorized into 5 surveillance definitions based on recent HCF exposure. Annual CDI rates were calculated and evaluated by use of the χ2 test for trend and the χ2 summary test.

Results.

During the study period, there were significant increases in the overall incidence rates of HCF-onset, HCF-associated CDI (from 7.0 to 8.5 cases per 10,000 patient-days; P < .001); community-onset, HCF-associated CDI attributed to a study hospital (from 1.1 to 1.3 cases per 10,000 patient-days; P = .003); and community-onset, HCF-associated CDI not attributed to a study hospital (from 0.8 to 1.5 cases per 1,000 admissions overall; P < .001). For each surveillance definition of CDI, there were significant differences in the total incidence rate between HCFs.

Conclusions.

The increasing incidence rates of CDI over time and across healthcare institutions and the correlation of CDI incidence in different surveillance categories suggest that CDI may be a regional problem and not isolated to a single HCF within a community.

Type
Original Articles
Information
Infection Control & Hospital Epidemiology , Volume 31 , Issue 10 , October 2010 , pp. 1030 - 1037
Copyright
Copyright © The Society for Healthcare Epidemiology of America 2010

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