An Evaluation of Food as a Potential Source for Clostridium difficile Acquisition in Hospitalized Patients. (3rd October 2016)

• Record Type: Journal Article
• Authors: Kwon, Jennie H.; Lanzas, Cristina; Reske, Kimberly A.; Hink, Tiffany; Seiler, Sondra M.; Bommarito, Kerry M.; Burnham, Carey-Ann D.; Dubberke, Erik R.
• Is Part Of: Infection control and hospital epidemiology. Volume 37:Number 12(2016)
• Page Start: 1401
• Page End: 1407
• Publication Date: 2016-10-03
• Subjects: Nosocomial infections -- Epidemiology -- Periodicals; Health facilities -- Sanitation -- Periodicals; Hospital buildings -- Sanitation -- Periodicals; Cross Infection -- Periodicals; Epidemiology -- Periodicals; Hospitals -- Periodicals; Infection Control -- Periodicals; 614.44
• DOI: 10.1017/ice.2016.218
• Languages: English
• ISSNs: 0899-823X

Abstract

Abstract : OBJECTIVE: To determine whether Clostridium difficile is present in the food of hospitalized patients and to estimate the risk of subsequent colonization associated with C. difficile in food. METHODS: This was a prospective cohort study of inpatients at a university-affiliated tertiary care center, May 9, 2011–July 12, 2012. Enrolled patients submitted a portion of food from each meal. Patient stool specimens and/or rectal swabs were collected at enrollment, every 3 days thereafter, and at discharge, and were cultured for C. difficile . Clinical data were reviewed for evidence of infection due to C. difficile. A stochastic, discrete event model was developed to predict exposure to C. difficile from food, and the estimated number of new colonization events from food exposures per 1, 000 admissions was determined. RESULTS: A total of 149 patients were enrolled and 910 food specimens were obtained. Two food specimens from 2 patients were positive for C. difficile (0.2% of food samples; 1.3% of patients). Neither of the 2 patients was colonized at baseline with C. difficile . Discharge colonization status was available for 1 of the 2 patients and was negative. Neither was diagnosed with C. difficile infection while hospitalized or during the year before or after study enrollment. Stochastic modeling indicated contaminated hospital food would be responsible for less than 1 newly colonized patient per 1, 000 hospital admissions. CONCLUSIONS: The recovery of C. difficile from the food of hospitalized patients was rare. Modeling suggests hospital food is unlikely to be a source of C. difficile acquisition. Infect Control Hosp Epidemiol 2016;1401–1407