Dangerous diarrheal bacterium found on asymptomatic patients

September 21, 2007

The bacterium that causes a highly contagious and sometimes deadly form of diarrhea is frequently carried by persons who do not have any of the disease symptoms, according to a study in the Oct. 15 issue of Clinical Infectious Diseases, now available online. These findings have dramatic implications for health care workers who have customarily treated and isolated only those patients who exhibit symptoms.

Clostridium difficile-associated disease (CDAD) is the most common health care-associated diarrheal disease in developed countries, with most infections occurring in hospitals, nursing homes, or other institutions. Generally, control measures have focused on placing patients with suspected or documented CDAD under contact precautions until the diarrhea resolved, then disinfecting their rooms. These infection control measures have been effective in reducing, but not eliminating, CDAD outbreaks.

This study offers reasons why those infection control efforts haven't been more successful: the bacteria may be thriving on asymptomatic patients and items in their immediate vicinity such as call buttons, bed rails, bedside tables, and telephones. The researchers found that spores were easily transferred from the patient's skin to investigators' hands.

"Our findings suggest that asymptomatic carriers of epidemic and non-epidemic C. difficile strains could contribute significantly to transmission in long-term care facilities," said senior author Curtis Donskey, MD, of the Louis Stokes Cleveland VA Medical Center. "Simple modifications of current infection control practices, including glove use by health care workers and use of 10 percent bleach for room disinfection, could reduce the risk of transmission from asymptomatic carriers."

Current guidelines recommend discontinuation of contact precautions for CDAD patients after diarrhea resolves. However, the authors found that nearly 25 percent of the asymptomatic carriers were patients who had previously had CDAD. Therefore, they propose extending the duration of contact precautions until the patient is discharged.

Patients with a previous history of CDAD and antibiotic use in the prior three months were likely to be asymptomatic carriers; patients with fecal incontinence were even more so.
-end-
Founded in 1979, Clinical Infectious Diseases publishes clinical articles twice monthly in a variety of areas of infectious disease, and is one of the most highly regarded journals in this specialty. It is published under the auspices of the Infectious Diseases Society of America (IDSA). Based in Arlington, Virginia, IDSA is a professional society representing more than 8,000 physicians and scientists who specialize in infectious diseases. For more information, visit www.idsociety.org.

Infectious Diseases Society of America

Related Bacterium Articles from Brightsurf:

Root bacterium to fight Alzheimer's
A bacterium found among the soil close to roots of ginseng plants could provide a new approach for the treatment of Alzheimer's.

Tuberculosis bacterium uses sluice to import vitamins
A transport protein that is used by the human pathogen Mycobacterium tuberculosis to import vitamin B12 turns out to be very different from other transport proteins.

Bacterium makes complex loops
A scientific team from the Biosciences and Biotechnology Institute of Aix-Marseille in Saint-Paul lez Durance, in collaboration with researchers from the Max Planck Institute of Colloids and Interfaces in Potsdam and the University of Göttingen, determined the trajectory and swimming speed of the magnetotactic bacterium Magnetococcus marinus, known to move rapidly.

Researchers show how opportunistic bacterium defeats competitors
The researchers discovered that Stenotrophomonas maltophilia uses a secretion system that produces a cocktail of toxins and injects them into other microorganisms with which it competes for space and food.

Genetic typing of a bacterium with biotechnological potential
Researchers at Kanazawa University describe in Scientific Reports the genetic typing of the bacterium Pseudomonas putida.

How the strep bacterium hides from the immune system
A bacterial pathogen that causes strep throat and other illnesses cloaks itself in fragments of red blood cells to evade detection by the host immune system, according to a study publishing December 3 in the journal Cell Reports.

The cholera bacterium can steal up to 150 genes in one go
EPFL scientists have discovered that predatory bacteria like the cholera pathogen can steal up to 150 genes in one go from their neighbors.

Exploiting green tides thanks to a marine bacterium
Ulvan is the principal component of Ulva or 'sea lettuce' which causes algal blooms (green tides).

The cholera bacterium's 3-in-1 toolkit for life in the ocean
The cholera bacterium uses a grappling hook-like appendage to take up DNA, bind to nutritious surfaces and recognize 'family' members, EPFL scientists have found.

Excellent catering: How a bacterium feeds an entire flatworm
In the sandy bottom of warm coastal waters lives Paracatenula -- a small worm that has neither mouth, nor gut.

Read More: Bacterium News and Bacterium Current Events
Brightsurf.com is a participant in the Amazon Services LLC Associates Program, an affiliate advertising program designed to provide a means for sites to earn advertising fees by advertising and linking to Amazon.com.