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Concurrent outbreaks with co-infection of norovirus and Clostridium difficile in a long-term-care facility

A Ludwig1, K Sato, P Schirmer

  • 1Epidemic Intelligence Service, Centers for Disease Control and Prevention, Atlanta, GA, USA. Alison.Ludwig@va.gov

Epidemiology and Infection
|February 26, 2013
PubMed

Insights

Simultaneous Clostridium difficile and norovirus infections occurred in a long-term-care facility. Four patients had co-infections, highlighting the need for better understanding of these dual outbreaks.

Area of Science:

  • Infectious Diseases
  • Epidemiology
  • Microbiology

Background:

  • Long-term-care facilities are vulnerable to infectious disease outbreaks.
  • Clostridium difficile and norovirus are common causes of gastroenteritis in healthcare settings.
  • Co-infections can complicate diagnosis and treatment.

Purpose of the Study:

  • To report an outbreak of simultaneous Clostridium difficile and norovirus infections.
  • To characterize the co-infecting strains.
  • To emphasize the need for further research into dual infections.

Main Methods:

  • Retrospective case review.
  • Clinical data collection for patients with acute gastroenteritis.
  • Molecular subtyping of Clostridium difficile and norovirus isolates.

Main Results:

  • Thirty patients presented with acute gastroenteritis.
  • Four patients had confirmed co-infection with Clostridium difficile (027 strain) and norovirus (genotype II.4 New Orleans).
  • Identical strains were observed in co-infected patients.

Conclusions:

  • Simultaneous Clostridium difficile and norovirus outbreaks can occur in long-term-care facilities.
  • Co-infection necessitates a deeper understanding of risk factors and clinical implications.
  • Improved diagnostic and testing strategies are required to manage these dual infections effectively.

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