title: Secular trends in hospital-acquired Clostridium difficile disease in the United States, 1987-2001.
abstract: We reviewed Clostridium difficile-associated disease (CDAD) data from the intensive care unit (ICU) and hospital-wide surveillance components of the National Nosocomial Infections Surveillance System hospitals during 1987-2001. ICU CDAD rates increased significantly only in hospitals with >500 beds (P<.01) and correlated with the duration of ICU stay (r=0.82; P<.05). Hospital-wide (non-ICU) rates increased only in hospitals with <250 beds (P<.01) and in general medicine patients versus surgery patients (P<.0001). CDAD predominated in general hospitals versus other facility types, and rates were significantly higher during winter versus nonwinter months (P<.01). Thus, prevention efforts should be targeted to high-risk groups in these settings.
authors.affiliation: Division of Healthcare Quality Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia, USA. larchibald@rtix.com.
authors.forename: Lennox K
authors.initials: LK
authors.lastname: Archibald
authors.forename: Shailen N
authors.initials: SN
authors.lastname: Banerjee
authors.forename: William R
authors.initials: WR
authors.lastname: Jarvis
mesh_terms: D016360:Clostridioides difficile / Q000302:isolation & purification*; D003428:Cross Infection / Q000453:epidemiology* / Q000382:microbiology; D004761:Enterocolitis, Pseudomembranous / Q000453:epidemiology* / Q000382:microbiology; D006742:Hospital Bed Capacity; D006761:Hospitals; D006801:Humans; D015994:Incidence; D007362:Intensive Care Units; D007902:Length of Stay; D012621:Seasons; D018571:Sentinel Surveillance; D014481:United States / Q000453:epidemiology