Journal of Preventive Medicine & Infectious Diseases

Abstract

Introduction: Clostridium difficile is a common cause of healthcare-associated infections, with significant clinical and economic impact. Epidemiological surveillance is a key tool in infection prevention and control programs for the early detection and control of outbreaks.

Objective: To describe an intrahospital outbreak of Clostridium difficile and to analyze its clinical and economic impact.

Methods: Investigation of a Clostridium difficile outbreak within the framework of institutional epidemiological surveillance. Study period: July 31, 2024 – August 23, 2024. The investigation included case identification and registration, temporal analysis using epidemic curves, and implementation of control measures. The cumulative incidence rate of infection during the outbreak period was compared with the historical incidence rate of the preceding period, and the relative risk (RR) was calculated. A control case was used to evaluate the associated costs.

Results: The index case was identified on July 31, 2024. Five secondary cases with a confirmed diagnosis of Clostridium difficile infection were recorded during the outbreak period. The institution's historical baseline incidence rate of Clostridium difficile infection is 1/2279 = 0.000439, and the rate during the outbreak period was 5/591 = 0.00846 (95% CI: 2.26–164.73; p = 0.0018). RR = 0.00846 / 0.000439 = 19.27. A secondary case was taken and the increased costs due to Clostridium difficile infection were evaluated, resulting in $5,047,010 and prolonging hospitalization for 11 more days.

Conclusion: In this study , the outbreak generated a significant clinical and economic impact: +11 days of hospitalization and 19 times greater risk of infection. Active epidemiological surveillance made it possible to detect the outbreak early and control its spread.

Infection Prevention and Control measures were essential to contain it and reduce its impact. Continuous surveillance, the PROA, hand hygiene, environmental cleaning, and training are key to preventing new outbreaks, highlighting the importance of infection prevention and control programs in patient safety.