Identifying Contact Time Required for Secondary Transmission of Clostridioides difficile Infections by Using...

Area of Science:

• Infectious Diseases
• Epidemiology
• Healthcare-Associated Infections

Background:

• Patient room shortages and the prevalence of other communicable diseases necessitate a re-evaluation of isolation protocols for Clostridioides difficile infection (CDI).
• Current isolation practices for CDI may strain hospital resources without a clear benefit in all settings.

Purpose of the Study:

• To investigate the rate of secondary CDI transmission in a hospital setting where CDI patients were not isolated.
• To determine the risk factors and transmission routes associated with CDI in the absence of contact isolation.

Main Methods:

• A retrospective study was conducted in a South Korean hospital using data from a real-time locating system and electronic medical records.
• Whole-genome sequencing was employed to identify secondary CDI transmission among direct and indirect contacts of CDI index patients.

Main Results:

• A total of 3,620 contact cases (909 direct, 2,711 indirect) were analyzed.
• Only two instances of secondary CDI transmission were observed (0.05% transmission rate).
• Transmission occurred via both direct contact (113 minutes) and environmental routes.

Conclusions:

• The study suggests that exhaustive standard preventive measures, including environmental decontamination, are effective in controlling CDI transmission.
• Contact isolation for CDI patients may not be necessary in non-outbreak settings, potentially alleviating hospital resource strain.