Varying rates of Clostridium difficile-associated diarrhea at prevention epicenter hospitals

SeJean Sohn; Michael Climo; Daniel Diekema; Victoria Fraser; Loreen Herwaldt; Susan Marino; Gary Noskin; Trish Perl; Xiaoyan Song; Jerome Tokars; David Warren; Edward Wong; Deborah S Yokoe; Theresa Zembower; Kent A Sepkowitz

doi:10.1086/502601

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Varying rates of Clostridium difficile-associated diarrhea at prevention epicenter hospitals

Journal article

Peer reviewed

Varying rates of Clostridium difficile-associated diarrhea at prevention epicenter hospitals

SeJean Sohn, Michael Climo, Daniel Diekema, Victoria Fraser, Loreen Herwaldt, Susan Marino, Gary Noskin, Trish Perl, Xiaoyan Song, Jerome Tokars, …

Infection control and hospital epidemiology, Vol.26(8), pp.676-679

08/2005

DOI: 10.1086/502601

PMID: 16156322

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https://digitalcommons.wustl.edu/cgi/viewcontent.cgi?article=1919&context=open_access_pubsView

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Abstract

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. To determine CDAD rates per 10,000 patient-days 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. Each center provided specific information for the study period, including case numbers, patient-days, and hospital characteristics. Case definitions and laboratory diagnoses of healthcare-associated CDAD were determined by each institution. Within institutions, case definitions remained consistent during the study period. Overall, mean annual case rates of CDAD were 12.1 per 10,000 patient-days (range, 3.1 to 25.1) and 7.4 per 1,000 hospital admissions (range, 3.1 to 13.1). No significant increases were observed in CDAD case rates during the 4-year interval, either at individual centers or in the Prevention Epicenter hospitals as a whole. Prevention Epicenter hospitals differed in their CDAD case definitions. Different case definitions used by the hospitals applied to a fixed data set resulted in a 30% difference in rates. No associations were identified between diagnostic test or case definition used and the relative rate of CDAD at a specific medical center. Rates of CDAD vary widely at tertiary-care centers across the United States. No significant increases in case rates were identified. The varying clinical and laboratory approaches to diagnosis complicated comparisons between hospitals. To facilitate benchmarking and comparisons between institutions, we recommend development of a more standardized case definition.

United States - epidemiology

Enterocolitis, Pseudomembranous - epidemiology

Cross Infection - prevention & control

Humans

Diarrhea - epidemiology

Diarrhea - prevention & control

Enterocolitis, Pseudomembranous - microbiology

Clostridium difficile - isolation & purification

Clostridium difficile - pathogenicity

Inpatients

Diarrhea - microbiology

Cross Infection - microbiology

Diarrhea - etiology

Enterocolitis, Pseudomembranous - prevention & control

Health Care Surveys

Cohort Studies

Cross Infection - epidemiology

Details

Title: Subtitle: Varying rates of Clostridium difficile-associated diarrhea at prevention epicenter hospitals
Creators: SeJean Sohn - Infection Control, Memorial Sloan-Kettering Cancer Center, 1275 York Avenue, New York, NY 10021, USA
Michael Climo
Daniel Diekema
Victoria Fraser
Loreen Herwaldt
Susan Marino
Gary Noskin
Trish Perl
Xiaoyan Song
Jerome Tokars
David Warren
Edward Wong
Deborah S Yokoe
Theresa Zembower
Kent A Sepkowitz
Contributors: Prevention Epicenter Hospitals (Institution)
Resource Type: Journal article
Publication Details: Infection control and hospital epidemiology, Vol.26(8), pp.676-679
DOI: 10.1086/502601
PMID: 16156322
NLM abbreviation: Infect Control Hosp Epidemiol
ISSN: 0899-823X
eISSN: 1559-6834
Publisher: United States
Grant note: UR8/CCU 215090 / ODCDC CDC HHS
Language: English
Date published: 08/2005
Academic Unit: Infectious Diseases; Epidemiology; Pathology; Internal Medicine
Record Identifier: 9983986364802771

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