Community Environmental Contamination of Toxigenic Clostridium difficile
| Autor: | Eugénie Bassères, Bradley T. Endres, Mohammed Khaleduzzaman, Julie Kuo, William L. Musick, Seth T. Walk, M. Jahangir Alam, Kevin W. Garey, Jennifer L. Christensen, Robert L. Atmar, Jonathan Amadio |
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| Rok vydání: | 2017 |
| Předmět: |
0301 basic medicine
medicine.medical_specialty Veterinary medicine Molecular epidemiology Hospitalized patients business.industry Similar distribution 030106 microbiology Clostridium difficile Contamination medicine.disease C difficile Anaerobic infection 03 medical and health sciences Infectious Diseases Oncology Epidemiology Medicine business |
| Zdroj: | Open Forum Infectious Diseases. 4 |
| ISSN: | 2328-8957 |
| Popis: | Background Clostridium difficile infection is often considered to result from recent acquisition of a C difficile isolate in a healthcare setting. However, C difficile spores can persist for long periods of time, suggesting a potentially large community environmental reservoir. The objectives of this study were to assess community environmental contamination of toxigenic C difficile and to assess strain distribution in environmental versus clinical isolates. Methods From 2013 to 2015, we collected community environmental swabs from homes and public areas in Houston, Texas to assess C difficile contamination. All positive isolates were tested for C difficile toxins A and B, ribotyped, and compared with clinical C difficile isolates obtained from hospitalized patients in Houston healthcare settings. Results A total of 2538 environmental samples were collected over the study period. These included samples obtained from homes (n = 1079), parks (n = 491), chain stores (n = 225), fast food restaurants (n = 123), other commercial stores (n = 172), and hospitals (n = 448). Overall, 418 environmental isolates grew toxigenic C difficile (16.5%; P < .001) most commonly from parks (24.6%), followed by homes (17.1%), hospitals (16.5%), commercial stores (8.1%), chain stores (7.6%), and fast food restaurants (6.5%). A similar distribution of ribotypes was observed between clinical and environmental isolates with the exception that ribotype 027 was more common in clinical isolates compared with environmental isolates (P < .001). Conclusions We identified a high prevalence of toxigenic C difficile from community environs that were similar ribotypes to clinical isolates. These findings suggest that interventions beyond isolation of symptomatic patients should be targeted for prevention of C difficile infection. |
| Databáze: | OpenAIRE |
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