[The effect of Clostridium difficile infection on length of hospital stay. A cohort study]

Clostridium difficile is responsible for a spectrum of diseases known as "Clostridium difficile infection" (CDI). It is currently the leading cause of nosocomial diarrhea in developed countries. This infection has been associated with both increased hospital stay and mortality, and to a greater likelihood of readmission. In our country these undesirable effects have not yet been characterized. Our objective was to quantify the increase in hospital stay attributable to infection by C.difficile.

A retrospective cohort study matched by age, sex and admission date, was conducted in a tertiary care university hospital during an outbreak of nosocomial transmission of CDI.

The cohort study included 38 infected, and 76 non-infected patients. Patients who developed CDI showed a higher proportion of malnutrition at admission (OR=10.3; 3.6 to 29.6), were exposed to a wider range of antibiotics (mean difference=1.5; 0.7-2.2), had a higher mortality (31.6% vs. 6.6% of controls, P<.001), and a longer hospital stay (median 31.5 days versus 5.5 days for controls, P<.001). After adjustment, infection by C.difficile was associated with an increase in hospital stay of 4 days (P<.001).

C.difficile infection has important consequences on the length of hospital stay, and therefore on health costs.