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A national survey of testing and management of asymptomatic carriage of C. difficile

Published online by Cambridge University Press:  20 May 2019

Preeta K. Kutty*
Affiliation:
Division of Healthcare Quality Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia
Susan E. Beekmann
Affiliation:
Infectious Disease Society of America Emerging Infections Network, Arlington, Virginia University of Iowa Carver College of Medicine, Iowa City, Iowa
Ronda L. Sinkowitz-Cochran
Affiliation:
Division of Healthcare Quality Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia
Erik R. Dubberke
Affiliation:
Washington University, St Louis, Missouri
David T. Kuhar
Affiliation:
Division of Healthcare Quality Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia
L. Clifford McDonald
Affiliation:
Division of Healthcare Quality Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia
Philip M. Polgreen
Affiliation:
Infectious Disease Society of America Emerging Infections Network, Arlington, Virginia University of Iowa Carver College of Medicine, Iowa City, Iowa
*
Author for correspondence: Preeta K. Kutty MD, MPH, Division of Healthcare Quality Promotion, Centers for Disease Control and Prevention, 1600 Clifton Road NE, MS A31 Atlanta, GA 30329-4027. Email: [email protected]

Abstract

A nationwide survey indicated that screening for asymptomatic carriers of C. difficile is an uncommon practice in US healthcare settings. Better understanding of the role of asymptomatic carriage in C. difficile transmission, and of the measures available to reduce that risk, are needed to inform best practices regarding the management of carriers.

Type
Concise Communication
Creative Commons
This work is classified, for copyright purposes, as a work of the U.S. Government and is not subject to copyright protection within the United States.
Copyright
© 2019 by The Society for Healthcare Epidemiology of America. All rights reserved

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Footnotes

PREVIOUS PRESENTATION: The information was presented in part at the Society for Healthcare Epidemiology of America (SHEA) Spring 2018 Conference on Thursday, April 19, 2018, in Portland, Oregon.

References

McDonald, LC, Gerding, DN, Johnson, S, et al. Clinical practice guidelines for Clostridium difficile infection in adults and children: 2017 Update by the Infectious Diseases Society of America (IDSA) and Society for Healthcare Epidemiology of America (SHEA). Clin Infect Dis 2018;66(7):e1e48.CrossRefGoogle Scholar
Pillai, SK, Beekmann, SE, Santibanez, S, Polgreen, PM. The Infectious Diseases Society of America emerging infections network: bridging the gap between clinical infectious diseases and public health. Clin Infect Dis 2014;58:991996.CrossRefGoogle Scholar
Dubberke, ER, Carling, P, Carrico, R, et al. Strategies to prevent Clostridium difficile infections in acute care hospitals: 2014 update. Infect Control Hosp Epidemiol 2014;35 suppl 2:S48S65.CrossRefGoogle ScholarPubMed
Galdys, AL, Nelson, JS, Shutt, KA, et al. Prevalence and duration of asymptomatic Clostridium difficile carriage among healthy subjects in Pittsburgh, Pennsylvania. J Clin Microbiol 2014;52:24062409.CrossRefGoogle ScholarPubMed
Schaffler, H, Breitruck, A. Clostridium difficile—from colonization to infection. Front Microbiol 2018;9:646.CrossRefGoogle Scholar
Furuya-Kanamori, L, Marquess, J, Yakob, L, et al. Asymptomatic Clostridium difficile colonization: epidemiology and clinical implications. BMC Infect Dis 2015;15:516.CrossRefGoogle ScholarPubMed
Crobach, MJT, Vernon, JJ, Loo, VG, et al. Understanding Clostridium difficile colonization. Clin Microbiol Rev 2018;31(2):pii: e0002117. doi: 10.1128/CMR.00021-17.CrossRefGoogle ScholarPubMed
Longtin, Y, Paquet-Bolduc, B, Gilca, R, et al. Effect of detecting and isolating Clostridium difficile carriers at hospital admission on the incidence of C. difficile infections: a quasi-experimental controlled study. JAMA Intern Med 2016;176:796804.CrossRefGoogle ScholarPubMed
Grigoras, CA, Zervou, FN, Zacharioudakis, IM, Siettos, CI, Mylonakis, E. Isolation of C. difficile carriers alone and as part of a bundle approach for the prevention of Clostridium difficile infection (CDI): a mathematical model based on clinical study data. PLoS One 2016;11(6):e0156577.CrossRefGoogle ScholarPubMed
Paquet-Bolduc, B, Gervais, P, Roussy, JF, et al. Detection and isolation of C. difficile asymptomatic carriers during C. difficile infection outbreaks—an exploratory study. Clin Infect Dis 20 18;67(11):17811783. doi: 10.1093/cid/ciy425.Google Scholar
Johnson, S, Homann, SR, Bettin, KM, et al. Treatment of asymptomatic Clostridium difficile carriers (fecal excretors) with vancomycin or metronidazole. A randomized, placebo-controlled trial. Ann Intern Med 1992;117:297302.CrossRefGoogle ScholarPubMed