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2017 ; 17
(1
): 384
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Assessing the effect of patient screening and isolation on curtailing Clostridium
difficile infection in hospital settings
#MMPMID28577357
Maghdoori S
; Moghadas SM
BMC Infect Dis
2017[Jun]; 17
(1
): 384
PMID28577357
show ga
BACKGROUND: Patient screening at the time of hospital admission is not
recommended as a routine practice, but may be an important strategy for
containment of Clostridium difficile infection (CDI) in hospital settings. We
sought to investigate the effect of patient screening in the presence of
asymptomatic carriers and in the context of imperfect patient isolation. METHODS:
We developed and parameterized a stochastic simulation model for the transmission
dynamics of CDI in a hospital ward. RESULTS: We found that the transmission of
CDI in the hospital, either through asymptomatic carriers or as a results of
ineffective implementation of infection control practices, at the time of
hospital admission. The results show that, for a sufficiently high reproduction
number of CDI, the disease can persist within a hospital setting in the presence
of in-ward transmission, even when there are no asymptomatically colonized
patients at the time of hospital admission. CONCLUSIONS: Our findings have
significant public health and clinical implications, especially in light of the
emergence and community spread of hypervirulent CDI strains with enhanced
transmission rates and toxin production. Rapid detection of colonized patients
remains an important component of CDI control, especially in the context of
asymptomatic transmission. Screening of in-hospital patients with potential
exposure to colonized patients or contaminated environment and equipment can help
reduce the rates of silent transmission of CDI through asymptomatic carriers.