Accepted for Publication: March 22, 2013.
Published Online: June 17, 2013. doi:10.1001/jamainternmed.2013.7056.
Study concept and design: Chitnis, Holzbauer, Bamberg, Farley, Dumyati, Beldavs, Dunn, Gould, Gerding, McDonald, Lessa.
Acquisition of data: Holzbauer, Winston, Bamberg, Lyons, Farley, Dumyati, Wilson, Beldavs, Beldavs, Dunn, MacCannell, Gerding, McDonald.
Analysis and interpretation of data: Chitnis, Holzbauer, Belflower, Winston, Farley, Wilson, Beldavs, Gould, MacCannell, Gerding, Lessa.
Drafting of the manuscript: Chitnis, Holzbauer, Belflower, Dunn, MacCannell, McDonald, Lessa.
Critical revision of the manuscript for important intellectual content: Chitnis, Holzbauer, Belflower, Winston, Bamberg, Lyons, Farley, Dumyati, Wilson, Beldavs, Dunn, Gould, MacCannell, Gerding, McDonald.
Statistical analysis: Chitnis, Holzbauer, Belflower, MacCannell, Lessa.
Administrative, technical, and material support: Holzbauer, Belflower, Bamberg, Wilson, Beldavs, Dunn, Gould, MacCannell, Gerding.
Study supervision: Winston, Farley, Dumyati, Beldavs, Dunn, Gould, Gerding, McDonald, Lessa.
Conflict of Interest Disclosures: None reported.
Funding/Support: This work was funded by the Emerging Infections Program Cooperative Agreement between study sites and the Centers for Disease Control and Prevention under the following grants: U50CK000201 (California), U50CK000194 (Colorado), U50CK000195 (Connecticut), U50CK000196 (Georgia), U50CK000203 (Maryland), U50CK000204 (Minnesota), U50CK000199 (New York), and U50CK000198 (Tennessee).
Disclaimer: The findings and conclusions in this study are those of the authors and do not necessarily represent the official position of the Centers for Disease Control and Prevention.
Previous Presentation: Some of the study data were presented in preliminary form as an abstract at Anaerobe 2012: the 11th Biennial Congress of the Anaerobe Society of the Americas; June 27 through July 1, 2012; San Francisco, California.
Additional Contributions: The following contributed to data collection and patient interviews: Joelle Nadle, MPH, Erin Garcia, MPH, Erin Parker, MPH, Kelly Kast, MSPH, Helen Johnston, MPH, Jim Meek, MPH, Leigh Ann Clark, MPH, Andrew Revis, MPH, Rebecca Perlmutter, MPH, Malorie Givan, MPH, Ruth Lynfield, MD, Rebecca Tsay, MPH, Deborah Nelson, RN, Samir Hannah, MD, L. Amanda Ingram, MPH, and Brenda Rue, RN. Susan Sambol, BS, MT, Laurica Petrella, BS, Lydia Anderson, BS, and Brandi Limbago, PhD, processed the Clostridium difficile specimens included in the study. Jessica Cohen, MPH, and Scott Fridkin, MD, critically reviewed the manuscript.