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Clostridium difficile (CD) Colitis: Background CD Epidemiology CD in Hospitals CD in Hospitals CD in Hospitals Previously Described Risk Factors Changing Epidemiology and New Risk Factors Antibiotic Trend Analysis Results University of Pittsburgh Medical Center (UPMC) Matched Case-Control Study Results Matched Case-Control Study Results Matched Case-Control Study Results Matched Case-Control Study Results Independent Antibiotic Risk Factors Independent Antibiotic Risk Factors Risk of CDAD According to Antibiotic Class Risk of CDAD According to Antibiotic Class Retrospective Cohort Study CDAD and Gastric Acid Suppression Environmental and Skin Contamination Environmental and Skin Contamination Environmental and Skin Contamination Environmental and Skin Contamination Environmental and Skin Contamination Environmental and Skin Contamination Undefined Risks: Four States, 2005 Infection Control Preventative Measures Infection Control Preventative Measures Infection Control Preventative Measures Infection Control Measures Johnson S et al. Am J Med. 1990;88:137-40. Johnson S et al. Am J Med. 1990;88:137-40. ** different from AHR and AHW (P<0.05); * different from AHR (P<0.05) ** different from AHR and AHW (P<0.05); * different from AHR (P<0.05) Isolation and Barrier Precautions Effect of Environmental Disinfection Effect of Environmental Disinfection Sporulation and the Epidemic Strain Bookmark 141 Bookmark 142 Sporulation and the Epidemic Strain The UPMC CD Bundle HA CDAD rate began increasing HA CDAD rate began increasing Enhanced Infection Control Measures Contact Precautions Increased Case Finding and Early Identification Informatics Tools CDAD Management Team CDAD Management Team Other CDAD Management Issues Other CDAD Management Issues Targeted Antibiotic Restriction Targeted Antibiotic Restriction Fluoroquinolone and Clindamycin Usage 102 and 74 genotypes were analyzed by MLVA in 2001 and 2005, respectively 102 and 74 genotypes were analyzed by MLVA in 2001 and 2005, respectively 102 and 74 genotypes were analyzed by MLVA in 2001 and 2005, respectively 102 and 74 genotypes were analyzed by MLVA in 2001 and 2005, respectively 102 and 74 genotypes were analyzed by MLVA in 2001 and 2005, respectively 102 and 74 genotypes were analyzed by MLVA in 2001 and 2005, respectively 102 and 74 genotypes were analyzed by MLVA in 2001 and 2005, respectively 102 and 74 genotypes were analyzed by MLVA in 2001 and 2005, respectively UPMC CD HAI and Severe Disease UPMC CD HAI and Severe Disease UPMC CD HAI and Severe Disease UPMC CD HAI and Severe Disease UPMC CD HAI and Severe Disease UPMC CD HAI and Severe Disease Conclusions Close Close Close Close Close Commentary from the Field