The Importance of Colonization with Clostridium difficile on Infection and Transmission

Abstract

Clostridium difficile infections (CDI) are the most common cause of healthcare-associated infections (HAI) in the USA, accounting for 12 % of all HAIs [1]. Reasons for such an increase are unknown but may relate to antibiotic use and evolution of a new, pathogenic strain, NAP1/BI/027. The Centers for Disease Control and Prevention (CDC) identifies C. difficile as one of only three organisms to be assigned a designation of an “urgent” threat level. Asymptomatic colonization with C. difficile is much more common than symptomatic CDI and has been documented to contribute to new cases of CDI. Despite this knowledge, approaches to managing and preventing transmission from asymptomatically colonized patients are lacking. Enhanced cleaning, avoidance of unnecessary antimicrobials, and use of gowns and gloves for patients with CDI are the cornerstone of C. difficile management in patients with known disease. Infection control interventions to prevent transmission from asymptomatically colonized patients have not been determined.

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Conflict of Interest

Carey-Ann Burnham reports grants from Cepheid, bioMerieux and Accelerate Diagnostics. Erik Dubberke reports grants and personal fees from Sanofi Pasteur and Merck. Surbhi Leekha received honorarium from the American Hospital Association/Health Research and Educational trust. Daniel Morgan reports personal fees from Welch Allyn, grants from VA HSRD, other from IDSA, ASM, and SHEA for expenses to organize or present at national meetings and personal fees from 3M.

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Correspondence to Daniel J. Morgan.

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This article is part of the Topical Collection on Healthcare Associated Infections

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Morgan, D.J., Leekha, S., Croft, L. et al. The Importance of Colonization with Clostridium difficile on Infection and Transmission. Curr Infect Dis Rep 17, 43 (2015). https://doi.org/10.1007/s11908-015-0499-0

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Keywords

  • Clostridium difficile infections
  • CDI
  • Healthcare-associated infections
  • HAI