Transmission of Clostridium difficile from asymptomatically colonized or infected long-term care facility residents

Infection Control and Hospital Epidemiology : the Official Journal of the Society of Hospital Epidemiologists of America
Curtis J DonskeyDale N Gerding

Abstract

To test the hypothesis that long-term care facility (LTCF) residents with Clostridium difficile infection (CDI) or asymptomatic carriage of toxigenic strains are an important source of transmission in the LTCF and in the hospital during acute-care admissions. A 6-month cohort study with identification of transmission events was conducted based on tracking of patient movement combined with restriction endonuclease analysis (REA) and whole-genome sequencing (WGS). Veterans Affairs hospital and affiliated LTCF.ParticipantsThe study included 29 LTCF residents identified as asymptomatic carriers of toxigenic C. difficile based on every other week perirectal screening and 37 healthcare facility-associated CDI cases (ie, diagnosis >3 days after admission or within 4 weeks of discharge to the community), including 26 hospital-associated and 11 LTCF-associated cases. Of the 37 CDI cases, 7 (18·9%) were linked to LTCF residents with LTCF-associated CDI or asymptomatic carriage, including 3 of 26 hospital-associated CDI cases (11·5%) and 4 of 11 LTCF-associated cases (36·4%). Of the 7 transmissions linked to LTCF residents, 5 (71·4%) were linked to asymptomatic carriers versus 2 (28·6%) to CDI cases, and all involved transmission of epide...Continue Reading

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Citations

Mar 12, 2019·Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America·Melany Gonzalez-OrtaCurtis J Donskey
Jul 18, 2020·Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America·Jay WorleyLynn Bry
Dec 14, 2018·Infection Control and Hospital Epidemiology : the Official Journal of the Society of Hospital Epidemiologists of America·Heba AlhmidiCurtis J Donskey
Jan 7, 2020·Clinical Microbiology and Infection : the Official Publication of the European Society of Clinical Microbiology and Infectious Diseases·M GilboaUNKNOWN ShIC research group
Aug 21, 2021·American Journal of Infection Control·Jennifer L CadnumCurtis J Donskey
Aug 25, 2021·Open Forum Infectious Diseases·Chetan JinadathaCurtis J Donskey
Sep 24, 2021·Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America·Valerie M VaughnEmily S Spivak

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