Faculty Collaboration Database

Transmission Dynamics of Clostridioides difficile in 2 High-Acuity Hospital Units. Clin Infect Dis 2021 Jan 29;72(Suppl 1):S1-S7

Date

01/30/2021

Pubmed ID

33512524

Pubmed Central ID

PMC7844587

DOI

10.1093/cid/ciaa1580

Scopus ID

2-s2.0-85100683679 (requires institutional sign-in at Scopus site)   4 Citations

Abstract

BACKGROUND: The key epidemiological drivers of Clostridioides difficile transmission are not well understood. We estimated epidemiological parameters to characterize variation in C. difficile transmission, while accounting for the imperfect nature of surveillance tests.

METHODS: We conducted a retrospective analysis of C. difficile surveillance tests for patients admitted to a bone marrow transplant (BMT) unit or a solid tumor unit (STU) in a 565-bed tertiary hospital. We constructed a transmission model for estimating key parameters, including admission prevalence, transmission rate, and duration of colonization to understand the potential variation in C. difficile dynamics between these 2 units.

RESULTS: A combined 2425 patients had 5491 admissions into 1 of the 2 units. A total of 3559 surveillance tests were collected from 1394 patients, with 11% of the surveillance tests being positive for C. difficile. We estimate that the transmission rate in the BMT unit was nearly 3-fold higher at 0.29 acquisitions per percentage colonized per 1000 days, compared to our estimate in the STU (0.10). Our model suggests that 20% of individuals admitted into either the STU or BMT unit were colonized with C. difficile at the time of admission. In contrast, the percentage of surveillance tests that were positive within 1 day of admission to either unit for C. difficile was 13.4%, with 15.4% in the STU and 11.6% in the BMT unit.

CONCLUSIONS: Although prevalence was similar between the units, there were important differences in the rates of transmission and clearance. Influential factors may include antimicrobial exposure or other patient-care factors.

Author List

Khader K, Munoz-Price LS, Hanson R, Stevens V, Keegan LT, Thomas A, Pezzin LE, Nattinger A, Singh S, Samore MH

Authors

Ann B. Nattinger MD, MPH Associate Provost, Professor in the Medicine department at Medical College of Wisconsin
Liliana Pezzin PhD, JD Professor in the Institute for Health and Equity department at Medical College of Wisconsin

MESH terms used to index this publication - Major topics in bold

Clostridium Infections
Hospital Units
Humans
Retrospective Studies