In the current issue of Clinical Infectious Disease Daniel Caroff and colleagues published an elegant article on the epidemiology and prevention of Clostridium difficile colitis. Many of the points that they make need to be emphasized in terms of how we operationalize C diff prevention efforts. The most important points made in the paper are the following: 1) 10% of patients admitted to the hospital have asymptomatic C. diff colonization. This percentage is even higher in the following groups of patients: a. Patients with recent hospitalizations b. Patients who have received recent antibiotics c. Patients who have recently had C. diff 2) Up to 30% of hospital -acquired C diff is likely acquired from those who are asymptomatically colonized and shedding C diff. Based upon these 2 fundamental observations from the literature shouldn't we consider re-tooling our preventative efforts in the following ways? 1) Screening all admissions for asymptomatic C di