C. difficile infections in hospitals may far exceed estimates.(Clinical Rounds)

The prevalence of Clostridium difficile infections among hospitalized patients in the United States may be far higher than previously estimated, according to a survey of approximately 12,000 members of the Association for Professionals in Infection Control and Epidemiology.

Of every 1,000 inpatients, 13 are either infected or colonized with C, difficile, a rate that is 6-20 times higher than previously published rates.

The new data are from the first national prevalence study of C. difficile infection (CDI).

The survey recipients were asked for information on all their patients with CDI on a particular day between May and August 2008.

Based on these results, it is estimated that on any given day, at least 7, 178 inpatients in the United States have a C. difficile infection, Dr. William Jarvis, the study's principal investigator, said during a teleconference held by APIC to announce the results.

Given published CDI-associated median mortality estimates of 4.2% in the published literature, 301 of these patients would be expected to die of the infection. This is a conservative estimate, since higher mortality rates have been reported, said Dr. Jarvis, formerly of the Centers for Disease Control and Prevention. He is president and cofounder of a private consulting firm in health care epidemiology in Port Or-ford, Ore.

Survey respondents reported on a total of 1,443 patients with CDI who were seen at 648 hospitals in 47 states, representing 12.5% of all medical facilities in the country. These cases alone would cost an average $6.5 million extra in health care costs and increase the length of hospital stays by an average of 8,081 days (based on published rates of increased hospital stays caused by CDI). The cases also would be associated with an average of 61 deaths.