Clostridium difficile at a community hospital in the Bronx, New York: Incidence prevalence and risk factors from 2006 to 2008

BackgroundThe rate of Clostridium difficile has increased over the last decade. This study was undertaken to determine the incidence, prevalence, and risk factors for infection at a 460-bed community hospital in the Bronx, New York.MethodRetrospective study reviewing all patients with a positive stool test for C difficile toxin A/B from 2006 to 2008.ResultsThree hundred fifty-two stools were positive for toxin. Average age was 58 years; 4% of patients with stools positive for C difficile were asymptomatic; 7% had community-acquired infection; 57% of C difficile acquisition occurred in the hospital; and 36% were in patients who acquired C difficile from a health care facility prior to admission. The incidence of C difficile was 7.8 cases/10,000 days in 2006, 10.3 in 2007, and 9.7 in 2008. The prevalence was 6.2 cases per 1,000 admissions in 2006, 7.6 in 2007, and 7.0 in 2008. The increased prevalence was not uniform throughout the hospital.ConclusionAt a community hospital in the Bronx, the incidence of C difficile increased but at a lower rate than previously reported. Prior health facility contact accounted for one third of these cases. Rooms with clusters of patients with C difficile suggest environmental propagation of infection.