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Clostridium difficile is responsible for one quarter of antibiotic-associated diarrhea and is the most common healthcare-associated infection. The rates of C. difficile infection (CDI) dramatically increased in the past two decades, with more-severe courses and increased mortality. A considerable proportion of these infections are attributable to the hypervirulent and more toxigenic C. difficile strain “BI/NAP1/027” (restriction endonuclease analysis pattern, BI; pulsed-field gel electrophoreses pattern, NAP1; PCR ribotype designation, 027). However, data on the recent epidemiology of CDI have been lacking so far for the U.S. A retrospective, observational, nationwide study, performed from June 2011 through June 2016 in 128 VA Network hospi…