Nosocomial diarrhoea due to a single strain of Clostridium difficile: a prolonged outbreak in elderly patients - PubMed (original) (raw)
Nosocomial diarrhoea due to a single strain of Clostridium difficile: a prolonged outbreak in elderly patients
T D Cartmill et al. Age Ageing. 1992 Jul.
Abstract
An outbreak of diarrhoea occurred in an acute geriatric ward of a hospital (A). It affected six patients initially and was found to be due to a single strain of Clostridium difficile. There was little evidence for asymptomatic carriage of this strain or others in the hospital patients. The following three months saw an increase in the number of symptomatic cases of C. difficile disease in two peripheral hospitals, B and C. Patients had been moved from the outbreak ward to these hospitals. Of 18 cases in hospital B all 15 isolates saved for typing were of the 'outbreak' strain. Of three cases occurring in hospital C, only one was the 'outbreak' strain (a relapsed patient who was part of the original episode). There were seven further cases in geriatric and medical wards of hospital A. All six typed isolates were also the outbreak strain. By chance, four isolates from hospital A and four from hospital B pre-dating the outbreak were also available for typing and seven of these were found to be identical to the outbreak strain. This suggests that one strain of C. difficile was endemic in geriatric and medical facilities on two sites and was responsible for nosocomial diarrhoea over at least one year. The problems of optimal management and infection control in this situation are discussed.
Similar articles
- Management of an outbreak of Clostridium difficile-associated disease among geriatric patients.
Cherifi S, Delmee M, Van Broeck J, Beyer I, Byl B, Mascart G. Cherifi S, et al. Infect Control Hosp Epidemiol. 2006 Nov;27(11):1200-5. doi: 10.1086/507822. Epub 2006 Oct 23. Infect Control Hosp Epidemiol. 2006. PMID: 17080377 - Nosocomial infection with Clostridium difficile investigated by pyrolysis mass spectrometry.
Cartmill TD, Orr K, Freeman R, Sisson PR, Lightfoot NF. Cartmill TD, et al. J Med Microbiol. 1992 Nov;37(5):352-6. doi: 10.1099/00222615-37-5-352. J Med Microbiol. 1992. PMID: 1433258 - Control of an outbreak of diarrhoea in a vascular surgery unit caused by a high-level clindamycin-resistant Clostridium difficile PCR ribotype 106.
Ratnayake L, McEwen J, Henderson N, Nathwani D, Phillips G, Brown D, Coia J. Ratnayake L, et al. J Hosp Infect. 2011 Nov;79(3):242-7. doi: 10.1016/j.jhin.2011.06.013. Epub 2011 Aug 23. J Hosp Infect. 2011. PMID: 21864938 - [Hospital-acquired clostridium difficile-associated diarrhea].
Hu YJ. Hu YJ. Zhongguo Yi Xue Ke Xue Yuan Xue Bao. 2008 Oct;30(5):618-21. Zhongguo Yi Xue Ke Xue Yuan Xue Bao. 2008. PMID: 19024399 Review. Chinese. - The prevention of Clostridium difficile associated diarrhoea in hospital.
Jenkins L. Jenkins L. Nurs Times. 2004 Jun 29-Jul 6;100(26):56-7, 59. Nurs Times. 2004. PMID: 15318695 Review.
Cited by
- Clinical Practice Guidelines for Clostridium difficile Infection in Adults and Children: 2017 Update by the Infectious Diseases Society of America (IDSA) and Society for Healthcare Epidemiology of America (SHEA).
McDonald LC, Gerding DN, Johnson S, Bakken JS, Carroll KC, Coffin SE, Dubberke ER, Garey KW, Gould CV, Kelly C, Loo V, Shaklee Sammons J, Sandora TJ, Wilcox MH. McDonald LC, et al. Clin Infect Dis. 2018 Mar 19;66(7):e1-e48. doi: 10.1093/cid/cix1085. Clin Infect Dis. 2018. PMID: 29462280 Free PMC article. - Recurrent Clostridium difficile infection: From colonization to cure.
Shields K, Araujo-Castillo RV, Theethira TG, Alonso CD, Kelly CP. Shields K, et al. Anaerobe. 2015 Aug;34:59-73. doi: 10.1016/j.anaerobe.2015.04.012. Epub 2015 Apr 27. Anaerobe. 2015. PMID: 25930686 Free PMC article. Review. - Clostridium difficile-associated diarrhea in adults.
Poutanen SM, Simor AE. Poutanen SM, et al. CMAJ. 2004 Jul 6;171(1):51-8. doi: 10.1503/cmaj.1031189. CMAJ. 2004. PMID: 15238498 Free PMC article. Review. - Comparison of restriction enzyme analysis, arbitrarily primed PCR, and protein profile analysis typing for epidemiologic investigation of an ongoing Clostridium difficile outbreak.
Rafferty ME, Baltch AL, Smith RP, Bopp LH, Rheal C, Tenover FC, Killgore GE, Lyerly DM, Wilkins TD, Schoonmaker DJ, Hannett GE, Shayegani M. Rafferty ME, et al. J Clin Microbiol. 1998 Oct;36(10):2957-63. doi: 10.1128/JCM.36.10.2957-2963.1998. J Clin Microbiol. 1998. PMID: 9738050 Free PMC article. - Identification of outbreak-associated and other strains of Clostridium difficile by numerical analysis of SDS-PAGE protein patterns.
Costas M, Holmes B, Ganner M, On SL, Hoffman PN, Worsley MA, Panigrahi H. Costas M, et al. Epidemiol Infect. 1994 Aug;113(1):1-12. doi: 10.1017/s0950268800051402. Epidemiol Infect. 1994. PMID: 8062865 Free PMC article.
MeSH terms
LinkOut - more resources
Full Text Sources
Medical