Epidemiology and Infection

Original Papers

Predictors of Clostridium difficile colitis infections in hospitals

R. RICCIARDIa1a2a3 c1, K. HARRIMANa4, N. N. BAXTERa5a6, L. K. HARTMANa7, R. J. TOWNa7 and B. A. VIRNIGa1a7

a1 Department of Surgery, University of Minnesota, Minneapolis, MN, USA

a2 Department of Colon and Rectal Surgery, Lahey Clinic, Burlington, MA, USA

a3 Institute for Clinical Research and Health Policy Studies, Tufts University, Boston, MA, USA

a4 Minnesota Department of Public Health, St. Paul, MN, USA

a5 Department of Surgery, St. Michael's Hospital, University of Toronto, Toronto, ON, Canada

a6 Department of Health Research, Policy, and Evaluation, University of Toronto, Toronto, ON, Canada

a7 Division of Health Policy and Management, University of Minnesota School of Public Health, Minneapolis, MN, USA


Hospital-level predictors of high rates of ‘Clostridium difficile-associated disease’ (CDAD) were evaluated in over 2300 hospitals across California, Arizona, and Minnesota. American Hospital Association data were used to determine hospital characteristics associated with high rates of CDAD. Significant correlations were found between hospital rates of CDAD, common infections and other identified pathogens. Hospitals in urban areas had higher average rates of CDAD; yet, irrespective of geographic location, hospital rates of CDAD were associated with other infections. In addition, hospitals with ‘high CDAD’ rates had slower turnover of beds and were more likely to offer transplant services. These results reveal large differences in rates of CDAD across regions. Hospitals with high rates of CDAD have high rates of other common infections, suggesting a need for broad infection control policies.

(Accepted July 11 2007)

(Online publication August 09 2007)


c1 Author for correspondence: R. Ricciardi, M.D., M.P.H., Department of Colon and Rectal Surgery, Lahey Clinic, 41 Mall Road, Burlington, MA 01805, USA. (Email: rocco.ricciardi@lahey.org)