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Journal of Clinical Microbiology, July 1998, p. 2076-2080, Vol. 36, No. 7
Department of Medical Microbiology,
University of Manitoba,1 and
St.
Boniface General Hospital,2 Winnipeg,
Manitoba, Canada
Received 26 September 1997/Returned for modification 19 November
1997/Accepted 8 April 1998
A questionnaire relating to Clostridium difficile
disease incidence and diagnostic practices was sent to 380 Canadian
hospitals (all with >50 beds). The national questionnaire response
rate was 63%. In-house testing was performed in 17.6, 61.5, and 74.2% of the hospitals with <300, 300 to 500, and >500 beds, respectively. The average test positivity rates were 17.2, 15.3, and 13.2% for hospitals with <300, 300 to 500, and >500 beds, respectively. The
average disease incidences were 23.5, 30.8, and 40.3 cases per 100,000 patient days in the hospitals with <300, 300 to 500, and >500 beds,
respectively. In the 81 hospitals where in-house testing was performed,
cytotoxin testing utilizing tissue culture was most common (44.4%),
followed by enzyme-linked immunosorbent assay (38.3%), culture for
toxigenic C. difficile (32.1%), and latex agglutination
(13.6%). The clinical criteria for C. difficile testing
were variable, with 85% of hospitals indicating that a test was done
automatically if ordered by a doctor. Our results show that C. difficile-associated diarrhea is a major problem in hospitals
with
0095-1137/98/$04.00+0
Copyright © 1998, American Society for Microbiology. All rights reserved.
Survey of Incidence of Clostridium
difficile Infection in Canadian Hospitals and Diagnostic
Approaches
200 beds. Despite a lower disease incidence in smaller
hospitals, there was a higher diagnostic test positivity rate. This may
reflect the preference of smaller hospitals for culture and latex
agglutination tests.
*
Corresponding author. Mailing address: Microbiology,
St. Boniface General Hospital, 409 Tache Ave., Winnipeg, MB R2H 2A6, Canada. Phone: (204) 237-2105. Fax: (204) 237-6065. E-mail:
malfa{at}cc.umanitoba.ca.
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