Assessing the effect of patient screening and isolation on curtailing Clostridium difficile infection in hospital settingsReport as inadecuate




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BMC Infectious Diseases

, 17:384

Healthcare-associated infection control

Abstract

BackgroundPatient screening at the time of hospital admission is not recommended as a routine practice, but may be an important strategy for containment of Clostridium difficile infection CDI in hospital settings. We sought to investigate the effect of patient screening in the presence of asymptomatic carriers and in the context of imperfect patient isolation.

MethodsWe developed and parameterized a stochastic simulation model for the transmission dynamics of CDI in a hospital ward.

ResultsWe found that the transmission of CDI in the hospital, either through asymptomatic carriers or as a results of ineffective implementation of infection control practices, at the time of hospital admission. The results show that, for a sufficiently high reproduction number of CDI, the disease can persist within a hospital setting in the presence of in-ward transmission, even when there are no asymptomatically colonized patients at the time of hospital admission.

ConclusionsOur findings have significant public health and clinical implications, especially in light of the emergence and community spread of hypervirulent CDI strains with enhanced transmission rates and toxin production. Rapid detection of colonized patients remains an important component of CDI control, especially in the context of asymptomatic transmission. Screening of in-hospital patients with potential exposure to colonized patients or contaminated environment and equipment can help reduce the rates of silent transmission of CDI through asymptomatic carriers.

KeywordsClostridium difficile Colonization Transmission dynamics Screening Reproduction number AbbreviationsCDIClostridium difficile infection

PCRPolymerase chain reaction

Electronic supplementary materialThe online version of this article doi:10.1186-s12879-017-2494-6 contains supplementary material, which is available to authorized users.





Author: Sara Maghdoori - Seyed M. Moghadas

Source: https://link.springer.com/







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