Abstract:
"Clostridioides difficile (C. difficile, C. diff.) is a spore-forming, bacterium that infects the gastrointestinal tract of humans. The bacterium is transmitted via a fecal-oral route and germinates in the large intestine. It proliferates in a dysbiotic gut microbiome, commonly found in the following populations, including the elderly, cancer patients, people undergoing antibiotic treatment, surgical patients, and immunocompromised patients. The bacterium is the most common nosocomial cause of infective diarrhea and is the most common hospital-associated infection (HAI). Shedding of spores by symptomatic and asymptomatic patients contributes to the deposition of C. difficile in the hospital and can establish C. difficile reservoirs in the hospital environments they occupy. Our study sampled seven frequently touched locations within the room of 13 patients with a C. difficile infection at diagnosis, before room cleaning, and after room cleaning. A two-way ANOVA demonstrated that there were no significant differences between room locations and time points. However, we found that in several locations, including the staff keyboard, visitor chair, and exhaust grille there was prevalence of C. difficile found in the samples after decontamination protocols. This emphasizes the need to better understand mechanisms of transmission between the environment-to-person as C. difficile reservoirs can persist after cleaning, and potentially infect the next patient to occupy the room. Our study sought to elucidate the dynamics of spore deposition in patient rooms that influence the likelihood of future patients getting infections."