OBJECTIVES: The diagnosis and treatment of Healthcare Associated Infections (HAI) have a significant impact on the care pathways and hospital costs; one of the most diffused HAI is Clostridium Difficile (CDI). The study aimed to assess the CDI distribution, related costs and possible areas of saving.  METHODS: Patients admitted at the TorVergata University Hospital between January and December 2013 presenting a CDI diagnosis were identified by analysing the Microbiology Laboratory Information Flow. Turn-Around-Time(TAT) was used to assess the efficiency of diagnosis with cultural exam and PCR methodologies. Through the analysis of clinical records, the CDI distribution in hospital departments and DRGs were examined. The economic value associated to each admission was calculated.  RESULTS: In the considered period, 1769 CDI tests were performed. 752 were valid for the analysis, 170 tests (22%) were positive and corresponded to 94 admissions. The TAT analysis showed that the PCR allowed saving about three days, compared to the cultural exam. The incidence of CDI was 8.2cases per 10,000bed-days/patient. More than half of cases were in: General Medicine(27;29%); Gastroenterology(14;15%); casualty department(12;13%); Infectious Diseases, respiratory Medicine, onco-haematology(respectively9;10%). ALOS was 31.8days (between5-132). The five most frequent DRGs were: DRG-572.Gastrointestinal and peritoneal infections(n=10), DRG-576.Septicemia without mechanical ventilation≥96hours(n=7); DRG-87.Respiratory insufficiency(n=6); DRG-179.Inflammatory bowel diseases(n=6); DRG-395.Red Blood Cells anomalies(n=5), accounting for 215,414€(29% of total). The economic value associated to whole admissions was 738,258€. The most significant fluctuation of income within the same DRG was in the more frequent one: DRG-572(1,742€-6,524€); and in the fifth DRG by frequency: DRG-395(3,394€-15,124€). Differences are due to regional DRG monitoring. The higher economic values were associated to bowel, liver or bone marrow transplantation (DRGs480-481).   CONCLUSIONS: This pool of evidence allows developing standardised pathways for early diagnosis and treatment that help improving patients’ care, increasing hospital efficiency and bed occupancy, reduce length of stay and improve measures for infection control.