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Many studies have documented the extension of the Clostridium difficile epidemic from the hospital into the community, but a comprehensive picture of community-based disease has been difficult to assemble. Now, Mayo Clinic researchers have reviewed data on all C. difficile infections seen in a Minnesota county between 1991 and 2005, using a clinical database that includes information on both hospital and community health delivery.
Approximately 40% of the 385 confirmed cases of C. difficile were community-acquired. Chronologic trends showed a surge in both nosocomial and community-acquired infections in the late 1990s. Compared to patients with nosocomial infection, those with community-acquired infection were younger (median age, 50 vs. 72)…