FINANCIAL BURDEN OF HOSPITAL-ACQUIRED CLOSTRIDIUM-DIFFICILE INFECTION

Clostridium difficile infection has become endemic in many hospitals a nd yet few data on the associated costs of such cases are available. W e prospectively followed 50 consecutive cases of C. difficile infectio n and 92 control patients, who were admitted to the same geriatric war ds within 72 h of the cases. Cases and controls had similar age, sex a nd major diagnosis distributions. Cases stayed significantly longer (m ean 21.3 days, median 20.5 days; P<0.001) in hospital than controls, i ncluding an average 14 days in a side room. Diarrhoea developed in cas es on average 10.8 days after admission, which, when compared with a m ean duration of stay for controls of 25.2 days, implies that C. diffic ile infection caused an increased duration of stay, as opposed to infe ction occurring because of longer residence. There was a significantly higher death rate in cases compared with controls (P<0.01). Antibioti c treatment of C. difficile infection cost an average of pound 47 per case. The average number of laboratory investigations per day was simi lar for cases and controls, but the increased length of stay meant an extra cost for tests of approximately pound 210 per case. Assuming hot el costs of pound 150 (pound 200) per day stay (in a side room), 94% o f the additional costs associated with C. difficile infection were due to increased duration of stay (pound 3850). The total identifiable in creased cost of C. difficile infection was, therefore, in excess of po und 4000 per case. Such high costs can be used to justify expenditure on personnel and/or other control measures to reduce the incidence of this hospital-acquired infection.