February 9, 2012

Deadly Hospital Infection: Who’s at Risk?

(Ivanhoe Newswire)-- The deadly infection Clostridium difficile also known as C. difficile is known to be spread in hospitals upon contact with a C.diffile infected patient.

A study is now reporting that only a small amount of cases of C.difficle are actually spread via contact from an already infected patient. These findings are important because the disease may not be controlled properly in a hospital setting using conventional strategies.

In a study led by Professor Tim Peto of the John Radcliffe Hospital in Oxford, UK, almost 30, 000 stool samples from nearly 15,000 patients were tested for C. difficile, with 4.4% (n=1282) found to be positive by specialized laboratory tests.

With further tests, the researchers identified 69 types of C. difficile and when combing this information with the clinical study, they found that the majority of cases of C. difficile infection were not linked to known cases (66%) and only 23% shared the same type of C. difficile as a ward known infected patient.

The authors were quoted as saying; "In this endemic setting with well-implemented infection control measures, up to three-quarters of new [C.difficile infections] are not easily explained by conventional assumptions of ward-based transmission from symptomatic patients and so may not be targeted by current interventions."

"A better understanding of other routes of transmission and reservoirs is needed to determine what other types of control interventions are required to reduce the spread of C. difficile"; the authors said.

In  an accompanying perspective article, Stephan Harbarth from the University of Geneva Hospitals, and Matthew Samore from the University of Utah School of Medicine, note that given the methods used in the study, the research cannot definitively answer some important clinical questions, such as the amount of benefit accrued by blocking transmission from symptomatic C. difficile infection cases, and the proportion of the C. difficile infections that are attributed to within-hospital transmission that actually represent already-infected individuals who come into the hospital.

Harbarth and Samore were quoted as saying: "The study by Sarah Walker and colleagues cannot provide definitive answers to these questions because it has significant limitations with respect to both issues."

SOURCE: PLoS Medicine, February 7, 2012