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Culturing and Maintaining Clostridium difficile in an Anaerobic Environment
Published on: September 14, 2013
The Impact of Infection Versus Colonization on Clostridioides difficile Environmental Contamination in Hospitalized
Bobby G Warren1,2, Nicholas A Turner1,2, Rachel Addison1,2
1Duke Center for Antimicrobial Stewardship and Infection Prevention, Durham, North Carolina, USA.
Asymptomatic carriers of Clostridioides difficile frequently contaminate hospital environments. This study suggests implementing contact precautions for patients colonized with C. difficile, particularly in bathrooms, to reduce environmental spread.
Area of Science:
- Infectious Diseases
- Hospital Epidemiology
- Microbiology
Background:
- Patients with Clostridioides difficile infections (CDIs) contribute to healthcare environment contamination.
- The role of asymptomatic C. difficile carriers in environmental contamination is not well understood.
- Current guidelines do not mandate contact precautions for asymptomatic C. difficile carriers.
Purpose of the Study:
- To evaluate C. difficile environmental contamination in rooms of adult inpatients with diarrhea.
- To compare contamination levels based on C. difficile status: infected, colonized, or negative.
Main Methods:
- Prospective cohort study of adult inpatients with diarrhea.
- Patients tested for C. difficile using PCR and EIA, stratified into infected, colonized, or negative groups.
- Environmental samples collected from patient areas, bathrooms, and care areas over three days.
Main Results:
- C. difficile was recovered in 93% of patient rooms.
- Contamination was frequent in rooms of infected (62%) and colonized (43%) patients.
- Higher C. difficile recovery rates were observed in bathrooms of infected and colonized patient rooms compared to negative rooms.
Conclusions:
- Patients colonized with C. difficile significantly contaminate the hospital environment.
- Contact precautions are recommended for rooms of C. difficile colonized patients, especially bathrooms.
- Findings support revising guidelines for managing asymptomatic C. difficile carriers.
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