Nosocomial Infection Increases Length of Stay

C. difficile is the most common cause of infectious diarrhea in hospital, and it is estimated that 10% of patients who become infected in hospital will die.

Scientists performed a retrospective observational cohort study analyzing data on 136, 877 admissions to the Ottawa Hospital (ON, Canada) between July 1, 2002, and March 31, 2009. A total of 1,393 patients acquired C. difficile in hospital during this time, and these patients spent 34 days in hospital compared with eight days for patients who did not have C. difficile. However, the investigators also found that patients who became infected with C. difficile tended to have illnesses that are more serious and would have been more likely to stay longer in hospital anyway. When they controlled for the level of illness using a mathematical model, they found that hospital-acquired C. difficile increased the length of stay in hospital by six days.

In adjusted analyses, hospital-acquired C. difficile was significantly associated with time to discharge, modified by baseline risk of death and time to acquisition of C. difficile. Alan J Forster, MD MSc, a senior scientist at the Ottawa Hospital Research Institute, said "We believe our study provides the most accurate measure yet of the impact of hospital-acquired C. difficile on length of hospital stay. C. difficile is a very serious problem for patients and for the health care system. However the good news is that tools such as used in this study provided us with more accurate information about C. difficile infection than we've ever had before, and this is helping us improve our infection-prevention efforts and also analyze their cost-effectiveness"

David A Enoch, MRCPath, a consultant microbiologist at the Peterborough and Stamford Hospitals, (UK), commented in the same journal, “That prevention and strict control measures are important for controlling the spread of the disease. Adhering to basic evidence-based precautions can rapidly reduce the transmission of C. difficile and its associated mortality. Surveillance is essential to assess the efficacy of interventions. "The study was published in the December 2011 issue of the Canadian Medical Association Journal.

Related Links:
Ottawa Hospital
Ottawa Hospital Research Institute
Peterborough and Stamford Hospitals