Genotypic correlation between post discharge Clostridiodes difficle infection (CDI) and previous unit-based contacts.
J Hosp Infect. 2020 Nov 07;:
Authors: Babady NE, Aslam A, McMillen T, Syed M, Zehir A, Kamboj M
OBJECTIVE: Cases of Clostridiodes difficile infection (CDI) diagnosed after hospital discharge account for a substantial proportion of new infections. It is unclear if post discharge infections originate from hospital-based transmission.
DESIGN: Retrospective cohort study.
SETTING: Tertiary care cancer center. Non outbreak setting.
METHODS: For all laboratory-identified cases of CDI in 2015- 2016, patients with post-discharge (PD) CDI within 8 weeks of their hospital stay were included in the study. Isolates from PD- CDI cases and their CDI positive unit-based contacts were first genotyped by MLST. Common strains were further examined by core genome sequencing (CGS) to evaluate transmission links.
RESULTS: Of 173 cases examined by MLST, 50 % of PD cases matched previous unit contacts. Next, 34 isolates, including 16 PD cases and their 18-unit contacts were examined by CGS. None were ≤3 SNVs apart. Seventy percent of PD cases had in-hospital antibiotic exposure before CDI onset in the community.
CONCLUSION: Our study results suggest that symptomatic CDI cases are not a substantial source of transmission to PD cases. Frequent antibiotic exposure in post-discharge CDI cases is an important target for surveillance and stewardship efforts.
PMID: 33171187 [PubMed - as supplied by publisher]