title: Healthcare resource utilization for recurrent Clostridium difficile infection in a large university hospital in Houston, Texas.
abstract: BACKGROUND
  There are limited data examining healthcare resource utilization in patients with recurrent Clostridium difficile infection (CDI).
  
  
  METHODS
  Patients with CDI at a tertiary-care hospital in Houston, TX, were prospectively enrolled into an observational cohort study. Recurrence was assessed via follow-up phone calls. Patients with one or more recurrence were included in this study. The location at which healthcare was obtained by patients with recurrent CDI was identified along with hospital length of stay. CDI-attributable readmissions, defined as a positive toxin test within 48 hours of admission and a primary CDI diagnosis, were also assessed.
  
  
  RESULTS
  372 primary cases of CDI were identified of whom 64 (17.2%) experienced at least one CDI recurrence. Twelve of 64 patients experienced 18 further episodes of CDI recurrence. Of these 64 patients, 33 (50.8%) patients with recurrent CDI were readmitted of which 6 (18.2%) required ICU care, 29 (45.3%) had outpatient care only, and 2 (3.1%) had an ED visit. Nineteen (55.9%) readmissions were defined as CDI-attributable. For patients with CDI-attributable readmission, the average length of stay was 6 ± 6 days.
  
  
  CONCLUSIONS
  Recurrent CDI leads to significant healthcare resource utilization. Methods of reducing the burden of recurrent CDI should be further studied.
authors: University of Houston College of Pharmacy, Houston, Texas, United States of America; Baylor St. Luke's Medical Center, Houston, Texas, United States of America.
authors: Samuel L
authors: SL
authors: Aitken
authors: Baylor St. Luke's Medical Center, Houston, Texas, United States of America.
authors: Tiby B
authors: TB
authors: Joseph
authors: University of Houston College of Pharmacy, Houston, Texas, United States of America; Baylor St. Luke's Medical Center, Houston, Texas, United States of America.
authors: Dhara N
authors: DN
authors: Shah
authors: Baylor St. Luke's Medical Center, Houston, Texas, United States of America.
authors: Todd M
authors: TM
authors: Lasco
authors: Baylor St. Luke's Medical Center, Houston, Texas, United States of America.
authors: Hannah R
authors: HR
authors: Palmer
authors: University of Houston College of Pharmacy, Houston, Texas, United States of America; Baylor St. Luke's Medical Center, Houston, Texas, United States of America; University of Texas School of Public Health, Houston, Texas, United States of America; Baylor College of Medicine, Houston Texas, United States of America.
authors: Herbert L
authors: HL
authors: DuPont
authors: Merck & Co., Whitehouse Station, New Jersey, United States of America.
authors: Yang
authors: Y
authors: Xie
authors: University of Houston College of Pharmacy, Houston, Texas, United States of America; Baylor St. Luke's Medical Center, Houston, Texas, United States of America; University of Texas School of Public Health, Houston, Texas, United States of America.
authors: Kevin W
authors: KW
authors: Garey
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D016360:Clostridioides difficile / Q000502:physiology*; D003015:Clostridium Infections / Q000188:drug therapy / Q000191:economics* / Q000382:microbiology; D003428:Cross Infection / Q000188:drug therapy / Q000191:economics* / Q000382:microbiology; D005260:Female; D006785:Hospitals, University / Q000191:economics* / Q000706:statistics & numerical data; D006801:Humans; D007902:Length of Stay / Q000191:economics*; D008297:Male; D008795:Metronidazole / Q000627:therapeutic use; D008875:Middle Aged; D011446:Prospective Studies; D012008:Recurrence; D013781:Texas; D014640:Vancomycin / Q000627:therapeutic use
chemical_list: D000900:Anti-Bacterial Agents; D008795:Metronidazole; D014640:Vancomycin