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Healthcare Resource Utilization for Recurrent Clostridium difficile Infection in a Large University Hospital in Houston,Texas
Authors:Samuel L Aitken  Tiby B Joseph  Dhara N Shah  Todd M Lasco  Hannah R Palmer  Herbert L DuPont  Yang Xie  Kevin W Garey
Institution:1. University of Houston College of Pharmacy, Houston, Texas, United States of America.; 2. Baylor St. Luke’s Medical Center, Houston, Texas, United States of America.; 3. University of Texas School of Public Health, Houston, Texas, United States of America.; 4. Baylor College of Medicine, Houston Texas, United States of America.; 5. Merck & Co., Whitehouse Station, New Jersey, United States of America.; Cornell University, United States of America,
Abstract:

Background

There are limited data examining healthcare resource utilization in patients with recurrent Clostridium difficile infection (CDI).

Methods

Patients with CDI at a tertiary-care hospital in Houston, TX, were prospectively enrolled into an observational cohort study. Recurrence was assessed via follow-up phone calls. Patients with one or more recurrence were included in this study. The location at which healthcare was obtained by patients with recurrent CDI was identified along with hospital length of stay. CDI-attributable readmissions, defined as a positive toxin test within 48 hours of admission and a primary CDI diagnosis, were also assessed.

Results

372 primary cases of CDI were identified of whom 64 (17.2%) experienced at least one CDI recurrence. Twelve of 64 patients experienced 18 further episodes of CDI recurrence. Of these 64 patients, 33 (50.8%) patients with recurrent CDI were readmitted of which 6 (18.2%) required ICU care, 29 (45.3%) had outpatient care only, and 2 (3.1%) had an ED visit. Nineteen (55.9%) readmissions were defined as CDI-attributable. For patients with CDI-attributable readmission, the average length of stay was 6±6 days.

Conclusion

Recurrent CDI leads to significant healthcare resource utilization. Methods of reducing the burden of recurrent CDI should be further studied.
Keywords:
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