Clostridium difficile-associated diarrhea in a VA medical center:: Clustering of cases, association with antibiotic usage, and impact on HIV-infected patients

A case-control study of patients with stools assayed for Clostridium difficile toxin over a 24-month period at a Veterans Affairs hospital found that the majority of cases (70.6%) occurred in temporal clusters. Clustering was particularly evident on a designated human immunodeficiency virus (HIV) unit. Thirty-four (75.5%) of 45 HIV-infected patients with C difficile-associated diarrhea (CDAD) died during their hospitalization. Third-generation cephalosporins were the antibiotics most strongly associated with CDAD (Infect Control Hosp Epidemiol 2001;22:42-45).