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Region Hovedstaden - en del af Københavns Universitetshospital

Asymptomatic carriers contribute to nosocomial Clostridium difficile infection: a cohort study of 4508 patients

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

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BACKGROUND & AIMS: Nosocomial infection with Clostridium difficile pose a considerable problem despite numerous attempts by health care workers to reduce risk of transmission. Asymptomatic carriers of C difficile might spread their infection to other patients. We investigated the effects of of asymptomatic carriers on nosocomial C difficile infections.

METHODS: We performed a population-based prospective cohort study at 2 university hospitals in Denmark, screening all patients for toxigenic C difficile in the intestine upon admittance, from October 1, 2012, to January 31, 2013. Screening results were blinded to patients, staff, and researchers. Patients were followed during their hospital stay by daily registration of wards and patient rooms. The primary outcomes were rate of C difficile infection in exposed and unexposed patients and factors associated with transmission.

RESULTS: C difficile infection was detected in 2.6% of patients not exposed to carriers and in 4.6% of patients exposed to asymptomatic carriers, at the ward level (odds ratio for infection if exposed to carrier, 1.79; 95% CI, 1.16-2.76). Amount of exposure correlated with risk of C difficile infection, from 2.2% in the lowest quartile to 4.2% in the highest quartile of exposed patients (P=.026). Combining the load of exposure to carriers and length of stay seemed to have an additive effect on the risk of contracting C difficile.

CONCLUSIONS: In a population-based prospective cohort study in Denmark, we found that asymptomatic carriers of toxigenic C difficile in hospitals increase risk of infection in other patients.

Udgave nummer5
Sider (fra-til)1031-1041
StatusUdgivet - 1 apr. 2017

ID: 49610470