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Necessary but Not Sufficient: A Comparison of Surveillance Definitions of Clostridium difficile–Associated Diarrhea

  • Thomas G. Fraser (a1) (a2), Cynthia Fatica (a2) and Steven M. Gordon (a1)


In this article, we describe our comparison of the Cleveland Clinic surveillance definition of Clostridium difficile–associated diarrhe and the definition mandated by the Ohio Department of Health. We found the definitions to be concordant only 71% of the time; the Ohio Department of Health definition identified 278 of the 391 cases identified by the Cleveland Clinic definition. Surveillance definitions mandated by the Ohio Department of Health overrepresented the number of cases attributable to nosocomial transmission at our institution.


Corresponding author

Department of Infectious Disease/S32, 9500 Euclid Avenue, Cleveland, OH 44195 (


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