1.Thompson, I. Clostridium difficile-associated disease: update and focus on non-antibiotic strategies. Age Ageing 2008;37:14–18.
2.Kuijper, EJ, Barbut, F, Brazier, JS, et al.Update of Clostridium difficile infection due to PCR ribotype 027 in Europe, 2008. Eurosurveillance 2008;13(31)pii: 18942.
3.McFarland, LV. Update on the changing epidemiology of Clostridium difficile-associated disease. Nat Clin Pract Gastroenterol Hepatol 2008;5:40–48.
4.Labbé, A-C, Poirier, L, MacCannell, D, et al.Clostridium difficile infections in a Canadian tertiary care hospital before and during a regional epidemic associated with the BI/NAP1/027 strain. Antimicrob Agents Chemother 2008;52:3180–3187.
5.Warny, M, Pepin, J, Fang, A, et al.Toxin production by an emerging strain of Clostridium difficile associated with outbreaks of severe disease in North America and Europe. Lancet 2005;366:1079–1084.
6.Debast, SB, Vaessen, N, Choudry, A, Wiegers-Ligtvoet, EA, van den Berg, RJ, Kuijper, EJ. Successful combat of an outbreak due to Clostridium difficile PCR ribotype 027 and recognition of specific risk factors. Clin Microbiol Infect 2009;15:427–434.
7.MacCannell, DR, Louie, TJ, Gregson, DB, et al.Molecular analysis of Clostridium difficile PCR ribotype 027 isolates from eastern and western Canada. J Clin Microbiol 2006;44:2147–2152.
8.Long, S, Fenelon, L, Fitzgerald, S, et al.First isolation and report of clusters of Clostridium difficile PCR 027 cases in Ireland. Eurosurveillance 2007;12(17):pii = 3183.
9.Aldeyab, MA, Monnet, DL, López-Lozano, JM, et al.Modelling the impact of antibiotic use and infection control practices on the incidence of hospital-acquired methicillin-resistant Staphylococcus aureus: a time-series analysis. J Antimicrob Chemother 2008;62:593–600.
10.Harris, AD, Shardell, M, El-Kamary, SS, Furano, JP, Miller, RR, Perencevich, EN. Statistical analysis and application of quasi experiments to antimicrobial resistance intervention studies. Clin Infect Dis 2007;45:901–907.
11.Aldeyab, MA, Harbarth, S, Vernaz, N, et al.Quasiexperimental study of the effects of antibiotic use, gastric acid-suppressive agents, and infection control practices on the incidence of Clostridium difficile-associated diarrhea in hospitalized patients. Antimicrob Agents Chemother 2009;53:2082–2088.
12.O'Neill, GL, Ogunsola, FT, Brazier, JS, Duerden, BI. Modification of a PCR ribotyping method for application as a routine typing scheme for Clostridium difficile. Anaerobe 1996;2:205–209.
13.Stubbs, SLJ, Brazier, JS, O'Neill, GL, Duerden, BI. PCR targeted to the 16S-23S rRNA gene intergenic spacer region of Clostridium difficile and construction of a library consisting of 116 different PCR ribotypes. J Clin Microbiol 1999;37:461–463.
14.Lewis, SJ, Heaton, KW. Stool form scale as a useful guide to intestinal transit time. Scand J Gastroenterol 1997;32:920–924.
15.McDonald, LC, Coignard, B, Dubberke, E, et al., and the Ad Hoc Clostridium difficile Surveillance Working Group. Recommendations for surveillance of Clostridium difficile-associated disease. Infect Control Hosp Epidemiol 2007;28:140–145.
16.WHO Collaborating Center for Drug Statistics Methodology. Guidelines for ATC classifications and DDD assignment. Oslo: WHO Collaborating Center; 2002.
19.Helfenstein, U. Box-Jenkins modelling in medical research. Stat Methods Med Res 1996;5:3–22.
20.Tobacman, JK. Assessment of comorbidity: a review. Clin Perform Quoi Health Care 1994;2:23–32.
21.Stone, SP, Cooper, BS, Kibbler, CC, et al.The ORION statement: guidelines for transparent reporting of outbreak reports and intervention studies of nosocomial infection. Lancet Infect Dis 2007;7:282–288.
22.Schwaber, MJ, Simhon, A, Block, C, Rovai, V, Ferderber, N, Shapiro, M. Factors associated with nosocomial diarrhea and Clostridium difficile-associated disease on the adult wards of an urban tertiary care hospital. Eur J Clin Microbiol Infect Dis 2000;19:9–15.
23.Muto, CA, Pokrywka, M, Shutt, K, et al.A large outbreak of Clostridium difficile-associated disease with an unexpected proportion of deaths and colectomies at a teaching hospital following increased fluoroquinolone use. Infect Control Hosp Epidemiol 2005;26:273–280.
24.Baxter, R, Ray, GT, Fireman, BH. Case-control study of antibiotic use and subsequent Clostridium difficile-associated diarrhea in hospitalized patients. Infect Control Hosp Epidemiol 2008;29:44–50.
25.Owens, RC Jr, Donskey, CJ, Gaynes, RP, Loo, VG, Muto, CA. Antimicrobial-associated risk factors for Clostridium difficile infection. Clin Infect Dis 2008;46(suppl 1):S19–S31.
26.Akhtar, AJ, Shaheen, M. Increasing incidence of Clostridium difficile-associated diarrhea in African-American and Hispanic patients: association with the use of proton pump inhibitor therapy. J Natl Med Assoc 2007;99:500–504.
27.Cadle, RM, Mansouri, MD, Logan, N, Kudva, DR, Musher, DM. Association of proton-pump inhibitors with outcomes in Clostridium difficile colitis. Am J Health Syst Pharm 2007;64:2359–2363.
28.Dial, S, Delaney, JA, Barkun, AN, Suissa, S. Use of gastric acid-suppressive agents and the risk of community-acquired Clostridium difficile-associated disease. JAMA 2005;294:2989–2995.
29.Apisarnthanarak, A, Zack, JE, Mayfield, JL, et al.Effectiveness of environmental and infection control programs to reduce transmission of Clostridium difficile. Clin Infect Dis 2004;39:601–602.
30.Regulation and Quality Improvement Authority (United Kingdom). Clostridium difficile—RQIA Independent Review. Review of the Outbreak of Clostridium difficile in the Northern Health and Social Care Trust, http://www.dhsspsni.gov.uk/assemblydocumentcdiffl4108.pdf. Accessed July 1, 2010.
31.Aldeyab, MA, Elshibly, SM, McElnay, JC, et al.An evaluation of compliance with an antibiotic policy in surgical wards at a general teaching hospital in Northern Ireland. Infect Control Hosp Epidemiol 2009;30:921–922.
32.Kuijper, EJ, Coignard, B, Tüll, P, ESCMID Study Group for Clostridium difficile, EU Member States, European Centre for Disease Prevention and Control. Emergence of Clostridium difficile-associated disease in North America and Europe. Clin Microbiol Infect 2006;12(suppl 6):2–18.
33.Morgan, OW, Rodrigues, B, Elston, T, et al.Clinical severity of Clostridium difficile PCR ribotype 027: a case-case study. PLoS one 2008;3(3):e1812.
34.Loo, VG, Poirier, L, Miller, MA, et al.A predominantly clonal multi-institutional outbreak of Clostridium difficile-associated diarrhea with high morbidity and mortality. N Engl J Med 2005;353:2442–2449.
35.Hubert, B, Loo, VG, Bourgault, A-M, et al.A portrait of the geographic dissemination of the Clostridium difficile North American pulsed-field type 1 strain and the epidemiology of C. difficile-associated disease in Quebec. Clin Infect Dis 2007;44:238–244.
36.Barbut, F, Gariazzo, B, Bonné, L, et al.Clinical features of Clostridium difficile-associated infections and molecular characterization of strains: results of a retrospective study, 2000-2004. Infect Control Hosp Epidemiol 2007;28:131–139.
37.Goorhuis, A, Van der Kooi, T, Vaessen, N, et al.Spread and epidemiology of Clostridium difficile polymerase chain reaction ribotype 027/toxinotype III in The Netherlands. Clin Infect Dis 2007;45:695–703.
38.Miller, M, Gravel, D, Mulvey, M, et al.Health care-associated Clostridium diffidi infection in Canada: patient age and infecting strain type are highly predictive of severe outcome and mortality. Clin Infect Dis 2010;50:194–201.
39.Kallen, AJ, Thompson, A, Ristaino, P, et al.Complete restriction of fluoroquinolone use to control an outbreak of Clostridium difficile infection at a community hospital. Infect Control Hosp Epidemiol 2009;30:264–272.
40.McElnay, JC, Scott, MG, Sidara, JY, Kearney, P. Audit of antibiotic usage in medium-sized general hospital over an 11-year period: the impact of antibiotic policies. Pharm World Sci 1995;17:207–213.
41.Al-Eidan, FA, McElnay, JC, Scott, MG, Kearney, MP. Clostridium difficile-associated diarrhoea in hospitalised patients. J Clin Pharm Ther 2000;25:101–109.
42.Valiquette, L, Cossette, B, Garant M-P, Diab, H, Pépin, J. Impact of a reduction in the use of high-risk antibiotics on the course of an epidemic of Clostridium difficile-associated disease caused by the hypervirulent NAP1/027 strain. Clin Infect Dis 2007;45(suppl 2):S112–S121.
43.Vonberg, RP, Kuijper, EJ, Wilcox, MH, et al.Infection control measures to limit the spread of Clostridium difficile. Clin Microbiol Infect 2008;14(suppl 5):2–20.