C. difficile widespread in non-healthcare settings – particularly on shoes

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October 01, 2021

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Source: JoJ et al. Executive Summary 18. Presented at: IDWeek; September 29th-Oct. 02/03/2021 (virtual meeting).

Disclosure: Jo does not report any relevant financial information. Please refer to the study for all relevant financial information from the other authors.


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Global monitoring of Clostridioids heavy showed it was widespread in isolates collected outside health facilities – particularly on the soles of shoes, according to IDWeek researchers.

“Our laboratory specializes in C. difficult, with a special focus on environmental microbiology “, Jinhee Jo, PharmD, a postdoctoral fellow in infectious diseases at the University of Houston, said Healio. “We had demonstrated at a high level beforehand C. difficult Contamination in parks and homes near Houston, Texas, and wanted to expand these efforts worldwide. “

JoJ et al.  Executive Summary 18. Presented at: IDWeek;  September 29th-Oct.  February 3rd, 2021 (virtual meeting).
JoJ et al. Executive Summary 18. Presented at: IDWeek; September 29th-Oct. February 3rd, 2021 (virtual meeting).

Between 2014 and 2017, Jo and colleagues collected environmental swabs from public areas, health facilities and shoe soles in the US and internationally and tested them to determine the prevalence and levels of C. difficult.

They collected a total of 11,986 isolates, mainly from the USA (n = 11,002), but also from 11 other countries, including Taiwan (n = 200) and India (n = 187). They categorized the samples into outdoor areas (n = 2,992), private apartments (n = 2,772), shoe soles (n = 1,420), public buildings (n = 1,104) or acute care facilities (n = 3,698).

A total of 26% of the samples were positive for C. difficult, according to Jo and colleagues, and sample positivity was similar between the US and non-US sampling sites.

In the US, homes (26.2%) and outdoor spaces (24.1%) had the highest positivity rate compared to public buildings (17.2%). Texas (n = 8,571) had the highest positivity rates for outdoor samples (27%) and similar for private homes (24%) and healthcare buildings (24%).

Shoe soles had the highest positivity rate (45%) with a similar ribotype (RT) distribution between shoe soles and environmental samples.

Among all samples, the researchers found that the most common RTs overall were F014-020 (16.4%), F106 (14.9%), and FP310 (11%).

“Our research showed that though C. difficult has historically been recognized as a healthcare-related infection C. difficult Spores are also prevalent in the global community – in non-healthcare facilities such as public buildings and outdoor areas, “said Jo. “This indicated a potential role for community surveillance and infection control efforts to protect those acquired by the community C. difficult Cases of infection. “

In a press release, Kevin W. Garey, PharmD, MS, FASHP, Professor of pharmaceutical practice at the University of Houston’s College of Pharmacy, said the results “are changing our understanding of” C. difficult“Including where it is found, how it is transmitted, and who it affects.

“We can no longer think about it C. difficult since it only exists in healthcare and the population at risk is no longer just the very sick patient in the hospital, ”said Garey, one of the researchers on the study. “Identifying this person at risk anywhere in the world should be a priority, whether the person is in a hospital or in the community.”


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