Bell J, Vatani J, Raad M, et al. - Researchers conducted a retrospective database review with the aim at determining the incidence of Clostridium difficile infection (CDI) within 90 days following elective spine surgery. In addition, they sought risk factors linked with its development and investigated how CDI affects postoperative outcomes. They reviewed a total of 63,667 Humana patients ages 20 to 84 years who underwent elective spine surgery between 2008 and 2016. Among these patients, 90-day incidence of CDI was 0.68%. Per findings, CDI enhances risk of readmission and mortality following elective spine surgery. In addition to preoperative fluoroquinolone use, following were identified as novel risk factors linked with the highest risk of CDI: decompensated chronic liver disease, posterior approaches, and multilevel involvement. Occurrence of CDI may be averted with perioperative optimization of modifiable risk factors.