The epidemiology of Clostridium difficile infection (CDI) indicates that the asymptomatic C. difficile carrier plays an important role in the transmission of this organism in the hospital setting, leading to new cases of CDI. A recent study examined the impact of isolating asymptomatic C. difficile carriers on CDI incidence.
Longtin et al. undertook a quasi-experimental controlled study in order to investigate the effect of detecting and isolating C. difficile asymptomatic carriers at hospital admission on the incidence of health care-associated CDI (HA-CDI). They screened 7599 patients admitted through the emergency department with an expected length of stay > 24 hours for C. difficile carriage by polymerase chain reaction (PCR). Patients who screened positive for C. difficile were placed into contact isolation precautions during their hospitalization. The incidence of HA-CDI was calculated before and after the intervention.
Although the study had some limitations, it showed that detecting and isolating C. difficile carriers was associated with a significant decrease in the incidence of HA-CDI. The authors estimated that the intervention prevented 63 of the 101 (62.4%) expected cases of CDI. This is an interesting study examining a novel approach to CDI prevention. If confirmed in subsequent studies, this strategy could help prevent HA-CDI.
Longtin Y, Paquet-Bolduc B, Gilca R, Garenc C, Fortin E, Longtin J, Trottier S, Gervais P, Roussy JF, Lévesque S, Ben-David D, Cloutier I, Loo VG.Effect of detecting and isolating Clostridium difficile carriers at hospital admission on the incidence of C difficile infections: A quasi-experimental controlled study. JAMA Internal Medicine. 2016;176(6):796-804. doi: 10.1001/jamainternmed.2016.0177
Link to the abstract of the article: http://jamanetwork.com/journals/jamainternalmedicine/article-abstract/2516765
Orion GenRead® C. difficile
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Orion GenRead C. difficile is a molecular test intended for detection of toxigenic Clostridium difficile from faecal samples from patients suspected of having C. difficile infection (CDI).