TY - JOUR
T1 - Asymptomatic carriers contribute to nosocomial Clostridium difficile infection
T2 - a cohort study of 4508 patients
AU - Blixt, Thomas
AU - Gradel, Kim Oren
AU - Homann, Christian
AU - Seidelin, Jakob Benedict
AU - Schønning, Kristian
AU - Lester, Anne
AU - Houlind, Jette
AU - Stangerup, Marie
AU - Gottlieb, Magnus
AU - Knudsen, Jenny Dahl
N1 - Copyright © 2017 AGA Institute. Published by Elsevier Inc. All rights reserved.
PY - 2017/4/1
Y1 - 2017/4/1
N2 - Background & Aims Nosocomial infections with Clostridium difficile present a considerable problem despite numerous attempts by health care workers to reduce risk of transmission. Asymptomatic carriers of C difficile can spread their infection to other patients. We investigated the effects of asymptomatic carriers on nosocomial C difficile infections. Methods We performed a population-based prospective cohort study at 2 university hospitals in Denmark, screening all patients for toxigenic C difficile in the intestine upon admittance, from October 1, 2012, to January 31, 2013. Screening results were blinded to patients, staff, and researchers. Patients were followed during their hospital stay by daily registration of wards and patient rooms. The primary outcomes were rate of C difficile infection in exposed and unexposed patients and factors associated with transmission. Results C difficile infection was detected in 2.6% of patients not exposed to carriers and in 4.6% of patients exposed to asymptomatic carriers at the ward level (odds ratio for infection if exposed to carrier, 1.79; 95% confidence interval, 1.16−2.76). Amount of exposure correlated with risk of C difficile infection, from 2.2% in the lowest quartile to 4.2% in the highest quartile of exposed patients (P =.026). Combining the load of exposure to carriers and length of stay seemed to have an additive effect on the risk of contracting C difficile. Conclusions In a population-based prospective cohort study in Denmark, we found that asymptomatic carriers of toxigenic C difficile in hospitals increase risk of infection in other patients.
AB - Background & Aims Nosocomial infections with Clostridium difficile present a considerable problem despite numerous attempts by health care workers to reduce risk of transmission. Asymptomatic carriers of C difficile can spread their infection to other patients. We investigated the effects of asymptomatic carriers on nosocomial C difficile infections. Methods We performed a population-based prospective cohort study at 2 university hospitals in Denmark, screening all patients for toxigenic C difficile in the intestine upon admittance, from October 1, 2012, to January 31, 2013. Screening results were blinded to patients, staff, and researchers. Patients were followed during their hospital stay by daily registration of wards and patient rooms. The primary outcomes were rate of C difficile infection in exposed and unexposed patients and factors associated with transmission. Results C difficile infection was detected in 2.6% of patients not exposed to carriers and in 4.6% of patients exposed to asymptomatic carriers at the ward level (odds ratio for infection if exposed to carrier, 1.79; 95% confidence interval, 1.16−2.76). Amount of exposure correlated with risk of C difficile infection, from 2.2% in the lowest quartile to 4.2% in the highest quartile of exposed patients (P =.026). Combining the load of exposure to carriers and length of stay seemed to have an additive effect on the risk of contracting C difficile. Conclusions In a population-based prospective cohort study in Denmark, we found that asymptomatic carriers of toxigenic C difficile in hospitals increase risk of infection in other patients.
U2 - 10.1053/j.gastro.2016.12.035
DO - 10.1053/j.gastro.2016.12.035
M3 - Journal article
C2 - 28063955
SN - 0016-5085
VL - 152
SP - 1031-1041.e2
JO - Gastroenterology
JF - Gastroenterology
IS - 5
ER -