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    Home » The High Cost of C. diff Infection and Relapse

    The High Cost of C. diff Infection and Relapse

    A $25K infection goes up another $10K with readmission

    March 1, 2018
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    Hospital wards with higher rates of antibiotic prescribing associated with increased risk for C. diff infection

    Clostridium difficile claims a staggering toll in patient infections annually, and a new study estimates the cost of treatment is nearly $25,000 based on five days of hospitalization. Recurrent infections, not an uncommon phenomenon with C. diff, add an additional two days and another $10,500.

    “This study is consistent with previous literature that has demonstrated a significant and substantial increase in [healthcare costs] for C. diff infection (CDI) over and above similar patients without CDI,” the authors reported. “It has also shown that having recurrent CDI is associated with substantial healthcare resource use as compared to similar CDI patients who do not have a recurrence. A significant strength of this study is that our data were drawn from a [broad] sample of the U.S. population, which increases its external validity.”

    Of 55,500 C. diff patients analyzed in the study, roughly one-fourth were recurrent infections. In patients with at least one recurrence, the risk for subsequent infections increases to the 45% to 65% range. Risk factors for recurrent CDI include continuation of inappropriate antibiotics, advanced age, and the use of antacid medications, the authors reported.

    Antibiotic stewardship is considered a prime preventive measure against C. diff, and almost two-thirds of the total patients received antimicrobials prior to their first infection.

    “The most important risk factor for CDI is disruption of the normal intestinal flora by exposure to prolonged use of antibiotics,” the authors concluded. “Reports have shown that 18%-25% of patients will experience their first primary episode of CDI recurrence following the completion of treatment with vancomycin or metronidazole.”

    That still leaves one-third caused by other factors, including transmission in healthcare settings by a spore-former that can resist environmental eradication. As infection preventionists are aware, these difficulties are compounded by the inability of alcohol hand rubs to inactivate C. diff spores on healthcare workers’ hands.

    “The rate of healthcare-associated CDI has been increasing, and the diagnosis of CDI is estimated to raise the cost of a hospitalization stay by 54% in the United States,” they concluded.

    “In addition, CDI has been associated with increasing morbidity and mortality, likely due to a combination of the changing virulence of C. difficile strains and the greater number of risk factors among vulnerable hospitalized patients.”

    REFERENCE

    1. Zhang D, Prabhu VS, Marcella SW, et al. Attributable Healthcare Resource Utilization and Costs for Patients with Primary and Recurrent Clostridium difficile Infection in the United States. Clin Infect Dis 2018; https://doi.org/10.1093/cid/cix1021. Published: 19 January 2018.

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    Hospital Infection Control & Prevention

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    Hospital Infection Control & Prevention (Vol. 45, No. 3) March 2018
    March 1, 2018

    Table Of Contents

    Flu Vaccine Efficacy Poor as H3N2 Outbreak Surges

    A Call to Action to Prevent Non-vent Pneumonia

    APIC-SHEA Forming Formidable Partnership

    Mind the Gap: SHEA Guidance on Ending Isolation

    Joint Commission Dings Hand Hygiene Lapses

    The High Cost of C. diff Infection and Relapse

    Antivaccine Attitudes: The Truth Is Out There

    Begin Test

    Buy this Issue/Course

    Financial Disclosure: Senior Writer Gary Evans, Editor Jesse Saffron, Editor Jill Drachenberg, Nurse Planner Patti Grant, RN, BSN, MS, CIC, Peer Reviewer Patrick Joseph, MD, and Editorial Group Manager Terrey L. Hatcher report no consultant, stockholder, speaker’s bureau, research, or other financial relationships with companies having ties to this field of study.

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