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Absence of Clostridium difficile stool carriage in asymptomatic volunteers

Abstract number: P1208

Hell M., Sickau K., Chmelizek G., Kern J.M., Maass M., Huhulescu S., Allerberger F.

Objectives and Background:Clostridium difficile emerged as important nosocomial pathogen. It is considered a leading cause of hospital-acquired diarrhea and can cause a potentially fatal illness.

Up to now there are only case-reports of symptomatic Health-Care-Workers (HCW) in the literature and only one report demonstrating a transmission of C. diff from patient to HCW on a molecular basis.

Therefore we initiated a prospective study to evaluate the prevalence of asymptomatic C. difficile stool carriage among healthcare workers with direct patient contact at a single university hospital compared to non-healthcare workers to asses the risk for HCWs acquiring Clostridium difficile Infection (CDI).

Methods: The study population consisted of 113 healthy HCWs (without any previous history of diarrhea) of different clinical departments with a high incidence of CDI in inpatients who were considered to be at high risk for acquiring C. difficile. The 128 healthy controls were purchased from the administration department of a big Food Company and from frozen stool samples.

Both groups were comparable in age- and sex-distribution.

During the time period April – July 2010, in total 241 stool specimens were collected. Stool samples were tested within 24h hours for toxgenic culture of C diff using selective culture media (Cycloserine/cefoxitin agar plates (bioMérieux, Vienna, Austria)) and incubated for 48 hours at 35±2 °C under anaerobic conditions.

51% of stool samples (58/113) of the study population and all stool samples of the controls (n = 128) were consecutively sent to the National Reference Laboratory for C. difficile at the Austrian Agency for Health and Food Safety (AGES) in Vienna for further confirmation through cultivation by broth enrichment technique.

Results: Both investigated study-groups (n-total= 241) were negative for Clostridium difficile by culture techniques (both direct plating and broth enrichment method).

Conclusion: We conclude therefore that healthy HCWs are probable not at risk for aquiring C diff spores from CDI-patients contacts and are themselves no risk for spreading C. diff spores in health-care facilities. Data about C.diff carriage in the community (up to 3%) possibly reflects an overestimation.

Session Details

Date: 07/05/2011
Time: 00:00-00:00
Session name: Abstracts of 21st ECCMID / 27th ICC
Subject:
Location: Milan, Italy, 7 - 10 May 2011
Presentation type:
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