Environmental shedding of toxigenic Clostridioides difficile by asymptomatic carriers: A prospective observational study
| Autor: | Shiraz Halevy, Gill Smollan, Olga Feld-Simon, Amitai Segev, Tal Zilberman-Daniels, O. Feld-Simon, Dalit Shachar, Gili Regev-Yochay, Adi Brom, C. Cohen, Ronen Fluss, Amnah Jbarien, Sharon Beni, Naty Keller, Eyal Meltzer, Mayan Gilboa, M. Gilboa, I. Tal, Nani Pinas-Zade, Howard Amital, Natasha Blausov, Hagit Yonath, E. Houri-Levi, Amit Hupert, Leonid Maizels, Carmit Rubin, Shmuel Stienlauf, Eyal Zimlichman, G. Regev-Yochay, Ilan Ben-Zvi, G. Rahav, A. Brom, Ilana Tal, Marina Romiantsev, Galia Rahav, Shoshi Segal, Esther Houri Levi, Kassem Sharif, S. Segal, Carmit Cohen, Y. Eden-Friedman, Shir Raibman-Spector, Yehudit Eden-Friedman, Haim Mayan, Avshalom Leibowitz, Gadi Segal |
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| Rok vydání: | 2020 |
| Předmět: |
Male
0301 basic medicine Microbiology (medical) medicine.medical_specialty Isolation (health care) Bacterial Toxins 030106 microbiology Asymptomatic Feces 03 medical and health sciences 0302 clinical medicine Bacterial Proteins Internal medicine Environmental Microbiology medicine Odd ratio Humans Infection control Prospective Studies 030212 general & internal medicine Aged Aged 80 and over Bacterial Shedding Inpatients Clostridioides difficile business.industry General Medicine Middle Aged Contamination Infectious Diseases Carriage Carrier State Clostridium Infections Female medicine.symptom business Asymptomatic carrier Clostridioides |
| Zdroj: | Clinical Microbiology and Infection. 26:1052-1057 |
| ISSN: | 1198-743X |
| DOI: | 10.1016/j.cmi.2019.12.011 |
| Popis: | Objectives The aim was to compare the burden of environmental shedding of toxigenic Clostridioides difficile among asymptomatic carriers, C. difficile-infected (CDI) patients and non-carriers in an inpatient non-epidemic setting. Methods C. difficile carriage was determined by positive toxin-B PCR from rectal swabs of asymptomatic patients. Active CDI was defined as a positive two-step enzyme immunoassay/polymerase chain reaction (EIA/PCR) test in patients with more than three unformed stools/24 hr. C. difficile environmental contamination was assessed by obtaining specimens from ten sites in the patients' rooms. Toxigenic strains were identified by PCR. We created a contamination scale to define the overall level of room contamination that ranged from clean to heavy contamination. Results One hundred and seventeen rooms were screened: 70 rooms inhabited by C. difficile carriers, 30 rooms by active CDI patients and 17 rooms by non C. difficile -carriers (control). In the carrier rooms 29 (41%) had more than residual contamination, from which 17 (24%) were heavily contaminated. In the CDI rooms 12 (40%) had more than residual contamination from which three (10%) were heavily contaminated, while in the control rooms, one room (6%) had more than residual contamination and none were heavily contaminated. In a multivariate analysis, the contamination score of rooms inhabited by carriers did not differ from rooms of CDI patients, yet both were significantly more contaminated than those of non-carriers odd ratio 12.23 and 11.16 (95% confidence interval 1.5–99.96 p 0.0195, and 1.19–104.49 p 0.035), respectively. Discussion Here we show that the rooms of C. difficile carriers are as contaminated as those of patients with active CDI and significantly more than those of non-carriers. |
| Databáze: | OpenAIRE |
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