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A new study published in the CMAJ (Canadian Medical Association Journal) reports that hospital-acquired Clostridium difficile infection increases length of stay in hospital by an average of six days. C. difficile is the most common cause of infectious diarrhea in hospitals, and it is estimated that 10 percent of patients who become infected will die.

Researchers used The Ottawa Hospital Data Warehouse to analyze data on 136,877 admissions to The Ottawa Hospital. A total of 1,393 patients acquired C. difficile in the hospital during this time, and these patients spent 34 days in the hospital, as compared to eight days for patients who did not have C. difficile. However, the researchers also found that patients who became infected with C. difficile tended to have more serious illnesses and would have been more likely to stay longer in the hospital anyway. When the researchers controlled for the level of illness using a mathematical model, they found that hospital-acquired C. difficile increased the length of stay in the hospital by six days.

"We believe our study provides the most accurate measure yet of the impact of hospital-acquired C. difficile on length of hospital stay," says lead author Dr. Alan Forster, a senior scientist at the Ottawa Hospital Research Institute and associate professor at the University of Ottawa. "And this is helping us improve our infection-prevention efforts and also analyze their cost-effectiveness."

In a related commentary Dr. David Enoch, Peterborough and Stamford Hospitals, United Kingdom, and co-author, writes 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," they state. "Surveillance is essential to assess the efficacy of interventions."

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