Is Clostridium difficile endemic in chronic-care facilities?

An apparent outbreak of Clostridium difficile diarrhoea on the chronic hospital ward of a long-term care facility prompted an investigation lasting seven months. Approximately a third of patients had stools that were positive for C difficile by either toxin or culture. Attempts to eradicate the infe...

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Bibliographic Details
Published inThe Lancet (British edition) Vol. 2; no. 8497; p. 11
Main Authors Bender, B S, Bennett, R, Laughon, B E, Greenough, 3rd, W B, Gaydos, C, Sears, S D, Forman, M S, Bartlett, J G
Format Journal Article
LanguageEnglish
Published England 05.07.1986
Subjects
Adult
Aged
Bacterial Toxins - analysis
Clostridium Infections - epidemiology
Clostridium Infections - prevention & control
Cross Infection - epidemiology
Diarrhea - epidemiology
Diarrhea - prevention & control
Disease Outbreaks - epidemiology
Feces - analysis
Feces - microbiology
Female
Hospitals, Chronic Disease
Hospitals, Special
Humans
Male
Maryland
Middle Aged
Maryland
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Summary:An apparent outbreak of Clostridium difficile diarrhoea on the chronic hospital ward of a long-term care facility prompted an investigation lasting seven months. Approximately a third of patients had stools that were positive for C difficile by either toxin or culture. Attempts to eradicate the infection by simultaneously treating all toxin-positive patients with metronidazole, limiting antibiotic use, and implementing enteric isolation were unsuccessful. New cases were both nosocomially acquired and imported into the facility. Of the C difficile toxin-positive patients, 34% had diarrhoea and 19/49 (38%) died during the study period. C difficile is not routinely sought by most clinical microbiology laboratories and may therefore be endemic in many long-term care facilities for the elderly.
ISSN:0140-6736
DOI:10.1016/s0140-6736(86)92559-6