Varying Rates of Clostridium Difficile-Associated Diarrhea at Prevention Epicenter Hospitals

Abstract

JSTOR is a not-for-profit service that helps scholars, researchers, and students discover, use, and build upon a wide range of content in a trusted digital archive. We use information technology and tools to increase productivity and facilitate new forms of scholarship. For more information about JSTOR, please contact support@jstor.org. The University of Chicago Press and BACKGROUND:Clostridium difficile-associated diarrhea (CDAD) causes substantial healthcare-associated morbidity. Unlike other common healthcare-associated pathogens, little comparative information is available about CDAD rates in hospitalized patients.OBJECTIVES: To determine CDAD rates per 10,000 patientdays and per 1,000 hospital admissions at 7 geographically diverse tertiary-care centers from 2000 to 2003, and to survey participating centers on methods of CDAD surveillance and case definition.METHODS: Each center provided specific information for the study period, including case numbers, patient-days, and hospital characteristics. Case definitions and laborator y diagnoses of healthcare-associated CDAD were determined by each institution. Within institutions, case definitions remained consistent during the study period.RESULTS: Overall, mean annual case rates of CDAD were

Health Care–AssociatedClostridium difficileInfection in Adults Admitted to Acute Care Hospitals in Canada: A Canadian Nosocomial Infection Surveillance Program Study

“…There may be a surveillance artifact: in different hospitals, the threshold for testing stool samples for C. difficile toxin may vary (especially in Quebec, where heightened public attention may have led to increased testing). Variation in toxin testing methods may also contribute, because these tests are not uniformly sensitive [19] Although it has been suggested that these discrepant findings may be the result of differing methodologies [20], this is not the case for our surveillance. Our study was conducted using a previously piloted methodology with a standardized case definition and patient questionnaire.…”

The Clostridium difficile problem: A South African tertiary institution's prospective perspective

“…[12] A possible explanation for this lower burden of disease may be the generally younger SA hospital patient population. The median age in our study was 41 years.…”

Prospective study of Clostridium difficile infections in Europe with phenotypic and genotypic characterisation of the isolates

“…Other factors that could explain differences in the incidence of CDAD include the awareness of physicians of C. difficile-associated infections, as well as strategies and methods used in laboratories for C. difficile testing [30]. Although the definition used for CDAD, based on toxigenic culture, probably overestimated the number of cases by detecting carriers of toxigenic strains, the mean incidence (2.45 ⁄ 10 000 patient-days) remains much lower than that in the USA and Canada, where incidence rates range from 4 to >25 ⁄ 10 000 admissions [15,17,31,32]. To facilitate benchmarking and comparison of rates of CDAD among institutions, a more standardised case definition and strategy for C. difficile testing should be implemented, as suggested by a recent European working group on C. difficile [33].…”