AJIC: American Journal of Infection Control
Volume 37, Issue 1 , Pages 15-19 , February 2009

What is on that keyboard? Detecting hidden environmental reservoirs of Clostridium difficile during an outbreak associated with North American pulsed-field gel electrophoresis type 1 strains

  • Donald M. Dumford III, MD

      Affiliations

    • Department of Medicine, University Hospitals of Cleveland, Cleveland, OH
    • ,
  • Michelle M. Nerandzic, BS

      Affiliations

    • Research Service, Cleveland Veterans Affairs Medical Center, Cleveland, OH
    • ,
  • Brittany C. Eckstein, BS

      Affiliations

    • Research Service, Cleveland Veterans Affairs Medical Center, Cleveland, OH
    • ,
  • Curtis J. Donskey, MD

      Affiliations

    • Research Service, Cleveland Veterans Affairs Medical Center, Cleveland, OH
    • Geriatric Research Education and Clinical Center, Cleveland Veterans Affairs Medical Center, Cleveland, OH
    • Corresponding Author InformationAddress correspondence to Curtis J. Donskey, MD, Research Service, Cleveland Veterans Affairs Medical Center, 10701 East Blvd, Cleveland, OH 44106.

References 

  1. Poutanen SM, Simor AE. Clostridium difficile–associated diarrhea in adults. CMAJ. 2004;171:51–58
  2. McDonald LC, Killgore GE, Thompson A, Owens RC, Kazakova SV, Sambol SP, et al. An epidemic, toxin gene-variant strain of Clostridium difficile. N Engl J Med. 2005;353:2433–2441
  3. Loo VG, Poirier L, Miller MA, Oughton M, Libman MD, Michaud S, et al. A predominantly clonal multi-institutional outbreak of Clostridium difficile–associated diarrhea with high morbidity and mortality. N Engl J Med. 2005;353:2442–2449
  4. Muto CA, Pokrywka M, Shutt K, Mendelsohn AB, Nouri K, Posey K, et al. A large outbreak of Clostridium difficile–associated disease with an unexpected proportion of deaths and colectomies at a teaching hospital following increased fluoroquinolone use. Infect Control Hosp Epidemiol. 2005;26:273–280
  5. Eckstein BC, Adams DA, Eckstein EC, Rao A, Sethi AK, Yadavalli GK, et al. Reduction of Clostridium difficile and vancomycin-resistant Enterococcus contamination of surfaces after an intervention to improve cleaning methods. BMC Infect Dis. 2007;7:61
  6. Riggs MM, Sethi AK, Zabarsky TF, Eckstein EC, Jump RL, Donskey CJ. Asymptomatic carriers are a potential source for transmission of epidemic and nonepidemic Clostridium difficile strains among long-term care facility residents. Clin Infect Dis. 2007;45:992–998
  7. Terhes G, Urban E, Soki J, Hamid KA, Nagy E. Community-acquired Clostridium difficile diarrhea caused by binary toxin, toxin A, and toxin B gene-positive isolates in Hungary. J Clin Microbiol. 2004;42:4316–4318
  8. Spigaglia P, Mastrantonio P. Molecular analysis of the pathogenicity locus and polymorphism in the putative negative regulator of toxin production (TcdC) among Clostridium difficile isolates. J Clin Microbiol. 2002;40:3470–3475
  9. Bidet P, Lalande V, Salauze B, Burghoffer B, Aresani V, Delmee M, et al. Comparison of PCR-ribotyping, arbitrarily primed PCR, and pulsed-field gel electrophoresis for typing Clostridium difficile. J Clin Microbiol. 2000;38:2484–2487
  10. Al-Nassir WN, Sethi AK, Nerandzic MM, Bobulsky GS, Jump RL, Donskey CJ. Comparison of clinical and microbiological response to treatment of Clostridium difficile–associated disease with metronidazole and vancomycin. Clin Infect Dis. 2008;47:56–62
  11. Larson HE, Price AB, Honour P, Borriello SP. Clostridium difficile and the etiology of pseudomembranous colitis. Lancet. 1978;1:1063–1066
  12. Dubberke ER, Reske KA, Yan Y, Olsen MA, McDonald LC, Fraser VJ. Prevalence of Clostridium difficile environmental contamination and strain variability in multiple health care facilities. Am J Infect Control. 2007;35:315–318

 Conflicts of interest: All authors report no conflicts of interest.

PII: S0196-6553(08)00750-5

doi: 10.1016/j.ajic.2008.07.009

AJIC: American Journal of Infection Control
Volume 37, Issue 1 , Pages 15-19 , February 2009

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