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Most cases of Clostridium difficile infection (CDI) are believed to result from healthcare exposure — particularly exposure to symptomatic patients with CDI. But is this belief correct?
To better define the epidemiology of CDI, researchers in the U.K. conducted a longitudinal study at four hospitals. From September 2007 through March 2011, all inpatients with diarrhea (defined as ≥3 stools within a 24-hour period that took the shape of a container) underwent testing for CDI. Enzyme immunoassay was used to screen all stool samples, and those that tested positive were cultured; culture-positive isolates were subjected to whole-genome sequencing. Sequences for samples obtained from April 2008 through March 2011 were compared with those for samp…