C. difficile infection (CDI) in a long-term acute care facility (LTAC)

Area of Science:

• Infectious Diseases
• Hospital Epidemiology
• Microbiology

Background:

• Clostridioides difficile infection (CDI) is a prevalent nosocomial infection.
• CDI significantly increases healthcare costs and hospital length of stay.
• Limited data exists on CDI incidence and prevalence in long-term acute care hospitals (LTACs).

Purpose of the Study:

• To investigate the incidence and prevalence of CDI in LTAC admissions.
• To identify asymptomatic carriers and unsuspected active CDI cases.
• To determine the rate of nosocomial CDI acquisition in an LTAC setting.

Main Methods:

• Prospective study of new LTAC admissions over one month.
• Stool samples collected for C. difficile antigen, toxin A/B testing.
• Patients monitored for diarrhea; positive cases cultured for strain typing.

Main Results:

• 12.9% of admitted patients tested positive for C. difficile antigen, with 6.5% having unsuspected active disease.
• An additional 13.8% of patients developed CDI during their LTAC stay.
• The nosocomial CDI rate was 3.12 per 1000 patient-days.

Conclusions:

• C. difficile carriage and unsuspected CDI, including epidemic strains, are present in LTACs.
• These patients may serve as reservoirs for CDI transmission.
• Novel strategies for CDI detection and prevention in LTACs are essential.