Rate of Transmission of Clostridium difficile Quantified

Hospitalized patients with CDI transmit C. difficile at rate 15 times higher than asymptomatic carriers
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FRIDAY, March 18, 2016 (HealthDay News) -- Hospitalized patients with Clostridium difficile infection (CDI) transmit C. difficile at a much higher rate than that of asymptomatic carriers and community sources, according to a report published in the April issue of the U.S. Centers for Disease Control and Prevention's Emerging Infectious Diseases.

David P. Durham, Ph.D., from the Yale School of Public Health in New Haven. Conn., and colleagues constructed a transmission model within and between hospital, community, and long-term care-facility settings to quantify the effect of hospital and community-based transmission and control measures of CDI.

The researchers found that hospitalized patients with CDI transmitted C. difficile at a rate 15 times that of asymptomatic patients, based on parametrizing the model from national databases and calibrating it to C. difficile prevalence and CDI incidence. Within the long-term care facility, the transmission rate from a person with CDI to an uncolonized person was 27 percent that of the hospital rate, while for persons in the community the transmission rate was 0.1 percent of that in the hospital.

"Despite lower transmission rates for asymptomatic carriers and community sources, these transmission routes have a substantial effect on hospital-onset CDI because of the larger reservoir of hospitalized carriers and persons in the community," the authors write. "Asymptomatic carriers and community sources should be accounted for when designing and evaluating control interventions."

Several authors disclosed financial ties to biopharmaceutical companies, including Sanofi-Pasteur, which funded the study.

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