Our understanding of the epidemiology of C. difficile infections continues to evolve. Dan recently
blogged on a new paper that shows that a high proportion of healthcare associated cases are not due to transmission in the hospital. Another new paper in BMC Infectious Diseases (full text
here) takes a look at an important question: are colonized healthcare workers involved in the transmission of Clostridium difficile in the hospital setting? At a large hospital in Australia a convenience sample of 128 healthcare workers (mostly nurses) had stool samples tested for C. difficile. Over 40% had known contact with C. difficile infected patients. Specimens were tested by ELISA and culture. No carriers were found. Given how difficult it is to get stool samples from HCWs, the authors should be commended.
Two other similar studies have been performed in the last 5 years. One found no colonized HCWs out of 112 tested, and the other found 4 of 30 (13% positive). So based on limited data it appears that colonization of healthcare workers probably does not play a major role in the transmission dynamics of C. difficile, though larger studies are needed.
Photo: Maddie Meyer/The Washington Post
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