Many Americans are carriers of deadly superbug C. diff that causes nearly half a million illnesses in US each year
It has generally been assumed that patients get the bacteria during their stay in the hospital, but the study suggests that there is a large pool of people who carry the organism that goes unrecognized and may pass it on to others and/or develop an infection themselves.
Nearly one in 10 patients admitted to a New York hospital with no symptoms of diarrhea were found to be carriers of superbug Clostridioides difficile (C. diff) -- which is contagious and causes life-threatening diarrhea -- suggesting that infections originate outside the hospital setting more often than thought.
It is generally assumed that patients get the bacteria during their stay in the hospital, says Dr. Sarah Baron, lead author of the study.
"However, when we tested patients being admitted to the hospital, we found that many of them were carrying the bacteria that causes this diarrhea in their bodies already and often went on to develop the infection," says Dr. Baron, director of inpatient quality improvement in the Department of Medicine in Montefiore Health System and assistant professor of medicine at the Albert Einstein College of Medicine.
The study also suggests that there is a large pool of people who carry the organism that go unrecognized and may pass it on to others and/or develop an infection themselves, says Baron. Based on their findings, the research team suggests that hospitals and other healthcare facilities could consider identifying carriers of C. diff as a strategy to prevent the spread of the infection.
According to the US Centers for Disease Control and Prevention (CDC), C. diff is a bacterium that causes life-threatening diarrhea and colitis, an inflammation of the colon, mostly in people who have had both recent medical care and antibiotics. The CDC estimates that it causes almost half a million illnesses in the US each year, and it can affect people of all ages.
"C. diff infections can be deadly. It is the most common healthcare-associated infection. About 1 in 5 patients who get C. diff will get it again. Infections occur most often in people who have taken antibiotics for other conditions. Within a month of diagnosis, 1 in 11 people over age 65 die of a healthcare-associated C. diff infection," says CDC.
The CDC's 2019 antibiotic resistance threats report says that more than 2.8 million antibiotic-resistant infections occur in the US each year, and more than 35,000 people die as a result. Besides, 223,900 cases of Clostridioides difficile occurred in 2017, and at least 12,800 people died.
For the current study, researchers at Montefiore tested 220 patients who showed no symptoms of C. diff infection when they were admitted between July 2017 and March 2018. Perirectal swabs were completed within 24 hours of admission, and the patients were followed for six months. Upon admission, 21 patients were identified as carriers.
Within six months, 38% of the carriers progressed to symptomatic C. diff infection compared to just 2% of the non-carriers, according to the analysis published in the Infection Control & Hospital Epidemiology, the journal of the Society for Healthcare Epidemiology of America.
"These findings might mean that we can predict who will develop C. diff and try to stop it before it starts. More work is needed to determine how we can protect everyone, even the patients who already have the bacteria in their colons, from developing this dangerous form of diarrhea," says Dr Baron in a released statement.