Contrary to prior knowledge, a newly published research study reveals that Clostridium difficile, commonly known as C. diff, spreads within intensive care units (ICUs) at an alarming rate – over three times more than previously perceived. This highly contagious infection often results in hemorrhagic diarrhea, abdominal discomfort, and fever; it can prove fatal in approximately 6% of the instances in the United States alone. Previous investigations showcased that patient-to-patient transmission of C. diff was a rare phenomenon. However, the recent study, which traces the bacterium’s trajectory within the hospital premises rather than limiting the focus to patients, brings to light the unnoticed dissemination of C. diff in healthcare environments.
Michael Rubin, MD, PhD, from the Spencer Fox Eccles School of Medicine at the University of Utah, who also happens to be the senior author on the study, reinstates the significance of this discovery, ‘We are potentially putting patients at unnecessary risk if we ignore this invisible spread of the disease,’ he states. The study, published in JAMA Network Open, took into account nearly 200 patients across two ICUs, sampled swabs from hospital room surfaces, and healthcare providers’ hands, collecting thousands of samples in total. Whole genome DNA sequencing facilitated precise tracking of bacterial movement. By mapping the genetic variations within bacterial samples, the team could successfully trace the movement of C. diff within the healthcare facilities and even establish whether two specimens originated from the same or different patients.
Results were startling: during 10% of ICU stays, C. diff was detected either on the patient or their immediate environment, and most strains were genetically identical, inherently suggesting patient-to-patient spread. This valuable insight carves the way for better preventive measures to curb the hidden spread of this disease. By tracking the bacterium’s dissemination across different surfaces and their connection to patients, the research team unraveled numerous potential transmission opportunities that otherwise might have slipped through the cracks of detection methods.
The team discerned that over half of these potential transmission events involved two patients who never shared hospital stay timelines, with the gap sometimes spanning weeks. This peculiar occurrence is attributed to the remarkable resilience of C. Diff that tends to survive outside the human body for extended durations, immune to regular antibacterial measures such as alcohol-based disinfectants. Consequently, bacteria from one patient could easily mark their territory within room surfaces, thereby creating a dormant threat for future patients.
Though not all strains of C. diff are harmful, the researchers warn that based on the spread of non-pathogenic C. diff, an undetected spread of the disease-instigating strains could be potentially prevalent. Therefore, it’s critical, as Rubin underscores, that healthcare providers heighten infection control measures and diligently abide by them. Practices such as the consistent use of personal protective equipment, including gloves and gowns, accompanied by religious adherence to hand hygiene, could serve as a formidable defense against this insidious transmission of C. diff.