Identifying C. difficile Carriers can Lower Infection Rates
HealthDay News — Detecting and isolating Clostridium difficile carriers can reduce the incidence of health care-associated C. difficile infection (HA-CDI), according to a study published online April 25 in JAMA Internal Medicine.
Yves Longtin, MD, from the Jewish General Hospital Sir Mortimer B. Davis in Montreal, and colleagues performed a controlled quasi-experimental study in an acute care facility. At admission, screening for C. difficile was performed by detecting the tcdB gene by polymerase chain reaction on a rectal swab. During their hospitalization, carriers were placed under contact isolation precautions. The changes in HA-CDI incidence were examined during the intervention period (17 periods of four weeks each) compared with the preintervention control period (120 periods of four weeks each).
The researchers found that 4.8% of the 7,599 eligible patients who were screened were identified as C. difficile carriers. Thirty-eight patients developed an HA-CDI during the intervention compared with 416 patients during the preintervention control period (3.0 versus 6.9 per 10,000 patient-days; P < 0.001). No immediate change was seen in the level of HA-CDIs on implementation (P = 0.92), but a significant 7 percent decrease in trend over time was seen per four-week period (rate ratio, 0.93; P = 0.02). The intervention was estimated to prevent 63 of the 101 expected cases (62.4%).
"If confirmed in subsequent studies, this strategy could help prevent HA-CDI," the authors write.
Two authors disclosed financial ties to the pharmaceutical industry; one author was co-applicant on a patent on methods, reagents, and kits for the assessment of bacterial infections.