Clostridium difficile hospitalizations in Louisiana: a 10 year review

Abstract

Clostridium difficile (CD) is a common cause of diarrhea in hospitalized patients and can cause more serious intestinal conditions such as pseudomembranous colitis, toxic megacolon, perforations of the colon, sepsis, and even death. Clostridium difficile associated disease (CDAD) is mainly a health care associated illness. Known risk factors for CDAD are antibiotics, gastrointestinal surgery/manipulation, long length of stay in health care settings, serious underlying illness, a compromised immune system, and advanced age (>65+). In 2004 a new epidemic strain of CD was identified as causing hospital outbreaks in several states. This new strain is more virulent and is more resistant to fluoroquinolone antibiotics. The Healthcare Cost and Utilization Project (HCUP) analyzed hospitalization discharge rates of CDAD in the United States (US) between 1993 and 2005 and reported that hospital discharges for CDAD doubled between 2001 and 2005. This study was done to see if Louisiana had similar trends in CDAD rates compared to the rest of the nation. Discharge records from the Louisiana Hospital Inpatient Discharge Database (LAHIDD) were analyzed for CDAD rates between 1999 and 2008 and were compared to the HCUPnet national estimates in the US. Trend and variance analyses were performed to compare demographics within Louisiana and overall trends to the US. Our results show that Louisiana had similar trends of CDAD rates compared to the US over the past 10 years. Furthermore, Louisiana also had a doubling of CDAD rates from 2001 to 2005.