Evaluation of environmental contamination of Clostridium difficile in hospital environmental surfaces
A retrospective cohort study was performed on Clostridium difficile positive patient isolates and hospital environmental isolates from their corresponding rooms between the months of June 2012 and February 2013 at St. Luke's Hospital in Houston, TX to determine whether there was an association between Clostridium difficiledifficile infection (CDI) causing C. difficile strains isolated from the patients and strains isolated from their corresponding rooms. The association between environmental surface persistence and C. difficile strain was also investigated to determine whether environmental persistence was strain dependent. PCR ribotyping, a molecular fingerprinting method, was used to analyze fifty-eight (58) environmental C. difficile DNA isolates and thirty-two (32) patient C. difficile DNA isolates. Cluster analysis was used to determine the distribution of prevalent C. difficile clusters of patients and environmental C. difficile DNA isolates. Seven clusters were identified with the use of C. difficile control strains using a similarity threshold of >71%, a level that has been established by previous publications. Of the seven clusters identified, cluster 004 included three of the five controls. Repeat analysis yielded similar results, which makes the findings difficult to interpret. Comparison of patient and environmental C. difficile DNA isolates indicated that there was no association between patient and environmental C. difficile DNA isolates. In conclusion, the use of molecular methods with higher discriminatory capabilities, such as multi-locus variable-number tandem repeat analysis (MLVA) and multi-locus sequence typing (MLST), are indicated to investigate the association between patient and environmental C. difficile isolates and consequently to also aid in determining the role of hospital environmental surfaces as a route of pathogen transmission.
Espinosa, Jo-Anne Meredith Gador, "Evaluation of environmental contamination of Clostridium difficile in hospital environmental surfaces" (2013). Texas Medical Center Dissertations (via ProQuest). AAI1549917.