The economic burden of Clostridium difficile

Clin Microbiol Infect. 2012 Mar;18(3):282-9. doi: 10.1111/j.1469-0691.2011.03571.x. Epub 2011 Jun 10.


Although Clostridium difficile (C. difficile) is the leading cause of infectious diarrhoea in hospitalized patients, the economic burden of this major nosocomial pathogen for hospitals, third-party payers and society remains unclear. We developed an economic computer simulation model to determine the costs attributable to healthcare-acquired C. difficile infection (CDI) from the hospital, third-party payer and societal perspectives. Sensitivity analyses explored the effects of varying the cost of hospitalization, C. difficile-attributable length of stay, and the probability of initial and secondary recurrences. The median cost of a case ranged from $9179 to $11 456 from the hospital perspective, $8932 to $11 679 from the third-party payor perspective, and $13 310 to $16 464 from the societal perspective. Most of the costs incurred were accrued during a patient's primary CDI episode. Hospitals with an incidence of 4.1 CDI cases per 100 000 discharges would incur costs ≥$3.2 million (hospital perspective); an incidence of 10.5 would lead to costs ≥$30.6 million. Our model suggests that the annual US economic burden of CDI would be ≥$496 million (hospital perspective), ≥$547 million (third-party payer perspective) and ≥$796 million (societal perspective). Our results show that C. difficile infection is indeed costly, not only to third-party payers and the hospital, but to society as well. These results are consistent with current literature citing C. difficile as a costly disease.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Aged, 80 and over
  • Clostridioides difficile / isolation & purification*
  • Clostridium Infections / economics*
  • Clostridium Infections / epidemiology*
  • Clostridium Infections / microbiology
  • Computer Simulation
  • Cross Infection / economics*
  • Cross Infection / epidemiology*
  • Cross Infection / microbiology
  • Diarrhea / economics
  • Diarrhea / epidemiology
  • Diarrhea / microbiology
  • Health Care Costs / statistics & numerical data*
  • Humans
  • Incidence
  • Models, Statistical
  • United States / epidemiology