Preventing Clostridium Difficile Infections

According to published data, Clostridium difficile infection (CDI) now rivals MRSA as the most common organism to cause healthcare-associated infections (HAIs) in the United States. The pro­portion of hospital discharges in which patients received a diagnostic code for CDI more than doubled between 2000 and 2003, and rates continued to increase in 2004 and 2005. “In addition to increased frequency of CDI, current research also shows that these infections are increasing in severity,” says Erik R. Dubberke, MD. CDI has been associated with increased lengths of hospital stay, higher costs, and greater morbidity and mortality. According to study data, CDI has been shown to increase lengths of hospital stay by about 3 days. Costs have also been significant; the total U.S. hospital costs for CDI management have been estimated at about $3.2 billion per year. The infection has been associated with attributable mortality rates of 16.7% at 1 year. New Guidance In 2008, a task force to create a concise compendium of recommendations for the prevention of common HAIs was appointed by the Society for Healthcare Epidemiology of America and the Infectious Diseases Society of America. Recommendations were published in the October 2008 supplement to Infection Control and Hospital Epidemiology and are available at The document is designed to help hospitals focus and prioritize their efforts to implement evidence-based practices for the prevention of HAIs, including CDI. According to the compendium recommendations, fluoroquinolones had been infrequently associated with CDI. However, new research has found that these agents are one of the primary predisposing antimicrobials associated with the infection. “Most antibiotics have been associated with CDI,” explains Dr. Dubberke....