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Is Clostridium difficile endemic in chronic-care facilities?
Lancet (London, England)
|July 5, 1986
Summary
Clostridium difficile (C. diff) infection outbreaks are common in long-term care facilities. Standard treatments and isolation failed to control this C. diff outbreak, highlighting the need for better detection and prevention strategies.
Area of Science:
- Infectious Diseases
- Epidemiology
- Geriatric Medicine
Background:
- Clostridium difficile infection (CDI) is a significant concern in healthcare settings, particularly long-term care facilities (LTCFs).
- An apparent outbreak of CDI prompted a seven-month investigation in a chronic hospital ward of an LTCF.
Purpose of the Study:
- To investigate an apparent outbreak of Clostridium difficile diarrhoea.
- To assess the effectiveness of eradication strategies including metronidazole treatment, antibiotic restriction, and enteric isolation.
Main Methods:
- Investigated an outbreak over seven months in an LTCF.
- Tested patient stools for C. difficile toxin or culture.
- Implemented treatment with metronidazole for toxin-positive patients, limited antibiotic use, and initiated enteric isolation.
Main Results:
- Approximately one-third of patients tested positive for C. difficile.
- Standard eradication attempts were unsuccessful in controlling the outbreak.
- New cases were acquired nosocomially and imported into the facility.
- 34% of toxin-positive patients experienced diarrhoea, and 38% died during the study.
Conclusions:
- Clostridium difficile may be endemic in LTCFs due to infrequent laboratory testing.
- Current control measures may be insufficient for managing CDI outbreaks in these settings.
- Further research into effective prevention and control strategies for CDI in LTCFs is warranted.