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An Outbreak of Severe Clostridium difficile–Associated Disease Possibly Related to Inappropriate Antimicrobial Therapy for Community-Acquired Pneumonia

  • Philip M. Polgreen (a1) (a2), Yi Yi Chen (a3), Joseph E. Cavanaugh (a3), Melissa Ward (a4), Stacy Coffman (a4), Douglas B. Hornick (a1), Daniel J. Diekema (a1) (a4) and Loreen A. Herwaldt (a1) (a2) (a4)...

We report a severe outbreak of Clostridium difficile infection. According to a chart review, half of the patients who received treatment for bacterial pneumonia before they developed C. difficile infection may not have had pneumonia. Excessive use of the hospital's new pneumonia care plan during the influenza season may have contributed to the intensity of this outbreak.

Corresponding author
University of Iowa Carver College of Medicine, 200 Hawkins Dr., Iowa City, IA 52242 (
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1.Muto, CA, Pokrywka, M, Shutt, K, et al. A large outbreak of Clostridium difficile-associated disease with an unexpected proportion of deaths and colectomies at a teaching hospital following increased fluoroquinolone use. Infect Control Hosp Epidemiol 2005;26:273280.
2.Pepin, J, Saheb, N, Coulombe, MA, et al. Emergence of fluoroquinolones as the predominant risk factor for Clostridium difficile-associated diarrhea: a cohort study during an epidemic in Quebec. Clin Infect Dis 2005;41:12541260.
3.McDonald, LC, Killgore, GE, Thompson, A, et al. An epidemic, toxin gene-variant strain of Clostridium difficile. N Engl J Med 2005;353:24332441.
4.Layton, BA, McDonald, LC, Gerding, DN, Liedtke, LA, Strausbaugh, LJ. Perceived increases in the incidence and severity of Clostridium difficile disease: an emerging threat that continues to unfold. In: Proceedings of 15th Annual Scientific Meeting of the Society for Healthcare Epidemiology of America; April 9-12, 2005; Los Angeles, CA. Abstract 66.
5.Kelly, CP, LaMont, JT. Clostridium difficile infection. Annu Rev Med 1998;49:375390.
6.Loo, VG, Poirier, L, Miller, MA, et al. A predominantly clonal multi-institutional outbreak of Clostridium difficile-associated diarrhea with high morbidity and mortality. N Engl J Med 2005;353:24422449.
7.Archibald, LK, Banerjee, SN, Jarvis, WR. Secular trends in hospital-acquired Clostridium difficile disease in the United States, 1987-2001. J Infect Dis 2004;189:15851589.
8.Houck, PM, Bratzier, DW, Nsa, W, Ma, A, Bartlett, JG. Timing of antibiotic administration and outcomes for Medicare patients hospitalized with community-acquired pneumonia. Arch Intern Med 2004;164:637644.
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Infection Control & Hospital Epidemiology
  • ISSN: 0899-823X
  • EISSN: 1559-6834
  • URL: /core/journals/infection-control-and-hospital-epidemiology
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