In the realm of hospital inpatient care, a new study reveals that patients who test positive upon admission for Clostridioides difficile (C. diff) but display no symptoms are significantly less likely to transmit the bacterium to other patients. However, the potential for such ‘carrier’ patients to become sick during the course of their hospital stay is high. These findings come from research conducted by scientists at the University of Michigan Medical School and have been published in the acclaimed Nature Medicine journal on September 18.
The study comprised extensive specimen culturing for C. diff and genomic testing on samples collected from all Intensive Care Unit (ICU) patients spanning a period of nine months. Through the course of this study, more than 9% of the enrolled patients were found to test positive for C. diff upon their hospital admission. Paradoxically, of those who initially tested negative upon admission, a minuscule 1% acquired the infection during their hospital stay. This substantial discrepancy challenges traditionally held beliefs surrounding high rates of patient-to-patient transmission of C. diff. Furthermore, those patients who tested positive upon admission exhibited a 24-fold higher likelihood of succumbing to a fully developed C. diff infection, which may present with a range of symptomatic manifestations from mild diarrhoea to life-threatening damage to the colon.
From these observations, it is suggested by the authors that some unidentified hospital conducive factor may promote the outgrowth of this bacterium in the patient’s digestive system. While antibiotics may be a contributing factor, they alone cannot account for this phenomenon. Lead author Evan Snitkin, PhD, and his team note that despite sustained prevention efforts, C. diff continues to be a major cause of healthcare-associated infection. However, the unexpectedly low rate of patient-to-patient transmission identified through this study underscores the efficacy of contemporary infection prevention strategies in mitigating C.diff cross-transmission from asymptomatic carriers, particularly in an ICU setting.
Snitkin further emphasizes the salient role of uncompromisingly stringent hand hygiene, routine disinfectant use, and single-patient rooms, wherever feasible. To build on this, Snitkin suggests that future endeavours to combat C.diff in hospital settings must focus on improving our understanding of the triggers instigating the transition from asymptomatic C.diff carriage to active infection.
Source: https://healthexec.com/topics/patient-care/care-delivery/patients-admitted-c-diff-not-significant-source-hospital-transmission