Assessment of Clostridium difficile–Associated Disease Surveillance Definitions, North Carolina, 2005

• DOI: 10.1086/528813
• Publication Date: 2008-02-02T00:09:39Z
• Authors: Preeta K. Kutty; Stephen R. Benoit; Christopher W. Woods; Arlene C. Sena; Susanna Naggie; Joyce Frederick; John Engemann; Sharon Evans; Brian C. Pien; Shailendra N. Ban...; Jeffery Engel; L. Clifford McDonald
• Keywords: Community hospital; Acute care

To determine the timing of community-onset Clostridium difficile-associated disease (CDAD) relative to patient's last healthcare facility discharge, association postdischarge cases with facility-onset cases, and influence on overall rates interhospital comparison CDAD.Retrospective cohort study for period January 1, 2005, through December 31, 2005.Catchment areas 6 acute care hospitals in North Carolina.We reviewed medical laboratory records date symptom onset, dates hospitalization, stool C. difficile toxin assay results patients CDAD who had diarrhea positive toxin-assay results. Cases were classified as if they diagnosed more than 48 hours after admission. defined community or within admission, also basis time since discharge: 4 weeks, community-onset, facility-associated (CO-HCFA); 4-12 indeterminate exposure; 12 community-associated. Pearson's correlation coefficient was used assess between monthly facility-onset, (HO-HCFA) CO-HCFA cases. We performed rate comparisons using HO-HCFA only both cases.Of 1046 442 (42%) 604 (58%) Of 94 (15%) CO-HCFA, 40 (7%) exposure, 208 (34%) A modest found across (r = 0.63, P < .001). Interhospital rankings changed 11 months included.A substantial proportion occur less weeks discharge from a facility, inclusion influences comparisons. Our findings support use proposed definition that includes discharge.