Evidence of transmission of Clostridium difficile in asymptomatic patients following admission screening in a tertiary care hospital.

Link to article at PubMed

Related Articles

Evidence of transmission of Clostridium difficile in asymptomatic patients following admission screening in a tertiary care hospital.

PLoS One. 2019;14(2):e0207138

Authors: Sheth PM, Douchant K, Uyanwune Y, Larocque M, Anantharajah A, Borgundvaag E, Dales L, McCreight L, McNaught L, Moore C, Ragan K, McGeer A, Broukhanski G

Abstract
BACKGROUND: Clostridium difficile (CD) is the leading cause of infectious health-care associated diarrhea. However, little is known regarding CD carriage and transmission amongst asymptomatic colonizers. We evaluated carriage, characterized strains and examined epidemiologic linkages in asymptomatic colonized CD patients.
METHODS: Rectal swabs from asymptomatic patients admitted to the general medicine ward from April 1-June 30 2012 were collected. PCR-confirmed CD colonies were ribotyped and characterized by Modified-Multi Locus Variable Number Tandem Repeat Analysis (MMLVA).
RESULTS: 1549-swabs were collected from 474-patients. Overall, 50/474(10.6%) were CD PCR-positive, 24/50 were colonized at admission, while 26/50 were first identified > = 72 hours after admission. Amongst the 50 CD PCR-positive patients, 90% were asymptomatically colonized and 80% of individuals carried toxigenic CD-strains, including ribotype-027 (5/45:11%). MMLVA revealed five-clusters involving 15-patients harboring toxigenic (4/5) and non-toxigenic CD strains (1/5). In two clusters, patients were CD positive on admission while in the other three clusters involving 10 patients, we observed CD transmission from asymptomatically colonized patients to 8 previously CD-negative patients.
CONCLUSIONS: We identified increasing rates of colonization during admission to medical wards. MMLVA typing effectively discriminated between strains and suggests that 20% of patients with CD colonization acquired their strain(s) from asymptomatically colonized individuals in hospital.

PMID: 30742636 [PubMed - in process]

Leave a Reply

Your email address will not be published. Required fields are marked *