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Research Letter
December 2017

Using Spatial and Temporal Mapping to Identify Nosocomial Disease Transmission of Clostridium difficile

Author Affiliations
  • 1Division of Hospital Medicine, Department of Medicine, University of California, San Francisco
  • 2Health Informatics, UCSF Health, University of California, San Francisco
  • 3Division of Rheumatology, Department of Medicine, University of California, San Francisco
  • 4San Francisco VA Medical Center, San Francisco, California
  • 5Center for Digital Health Innovation, University of California, San Francisco
JAMA Intern Med. 2017;177(12):1863-1865. doi:10.1001/jamainternmed.2017.5506

Hospital-acquired Clostridium difficile infection (CDI) is associated with significant morbidity and mortality.1 While risk factors like antibiotic exposure modulate susceptibility, infection control efforts aimed at reducing contact with infectious spores are critical to prevent nosocomial transmission.25 During hospitalization, patients visit many procedural and diagnostic common areas, presenting opportunities for contact with contaminated surfaces. However, these potential exposures are not typically captured in analyses evaluating disease transmission.6 Electronic health record (EHR) data allow us to track patients in time and space, but these data are not typically leveraged for infection control quality improvement efforts. We evaluated whether using a room within 24 hours of a patient with CDI was associated with increased risk of CDI in specific areas across our hospital.

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