1
|
Marlow C, Clayton JA, Minich N, Golonka G, Maruskin L, Jencson AL, Hailes JM, Choi H, Chatterjee P, Hwang M, Jinadatha C, Cadnum JL, Donskey CJ, Toltzis P. Molecular Epidemiology of Clostridioides difficile Colonization in Families With Infants. Open Forum Infect Dis 2024; 11:ofae299. [PMID: 38911950 PMCID: PMC11192056 DOI: 10.1093/ofid/ofae299] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2024] [Indexed: 06/25/2024] Open
Abstract
Background Community-associated Clostridioides difficile infection is a major public health hazard to adults and older children. Infants frequently excrete toxigenic C difficile asymptomatically in their stool, but their importance as a community reservoir of C difficile is uncertain. Methods Families of healthy infants were recruited at the baby's 4-month well child visit and were followed longitudinally until the baby was approximately 9 months old. Babies and mothers submitted stool or rectal swabs every 2 weeks that were cultivated for C difficile; fathers' participation was encouraged but not required. Clostridioides difficile isolates were strain-typed by fluorescent polymerase chain reaction ribotyping and by core genome multilocus sequence typing, and the number of families in whom the same strain was cultivated from >1 family member ("strain sharing") was assessed. Results Thirty families were enrolled, including 33 infants (3 sets of twins) and 30 mothers; 19 fathers also participated. Clostridioides difficile was identified in 28 of these 30 families over the course of the study, and strain sharing was identified in 17 of these 28. In 3 families, 2 separate strains were shared. The infant was involved in 17 of 20 instances of strain sharing, and in 13 of these, the baby was identified first, with or without a concomitantly excreting adult. Excretion of shared strains usually was persistent. Conclusions Clostridioides difficile strain sharing was frequent in healthy families caring for an infant, increasing the likelihood that asymptomatically excreting babies and their families represent a reservoir of the organism in the community.
Collapse
Affiliation(s)
- Christine Marlow
- Department of Pediatrics, Rainbow Babies and Children's Hospital, Cleveland, Ohio, USA
| | - Jason A Clayton
- Department of Pediatrics, Rainbow Babies and Children's Hospital, Cleveland, Ohio, USA
| | - Nori Minich
- Department of Pediatrics, Rainbow Babies and Children's Hospital, Cleveland, Ohio, USA
| | | | | | - Annette L Jencson
- Infectious Diseases Section (CJD) and Research Service (ALJ, JMH, JLC), Louis Stokes Cleveland Veterans Affairs Medical Center, Cleveland, Ohio, USA
| | - Jennifer M Hailes
- Infectious Diseases Section (CJD) and Research Service (ALJ, JMH, JLC), Louis Stokes Cleveland Veterans Affairs Medical Center, Cleveland, Ohio, USA
| | - Hosoon Choi
- Department of Medicine (CJ) and Department of Research (HC, PC, MH), Central Texas Veterans Healthcare System, Temple, Texas, USA
| | - Piyali Chatterjee
- Department of Medicine (CJ) and Department of Research (HC, PC, MH), Central Texas Veterans Healthcare System, Temple, Texas, USA
| | - Munok Hwang
- Department of Medicine (CJ) and Department of Research (HC, PC, MH), Central Texas Veterans Healthcare System, Temple, Texas, USA
| | - Chetan Jinadatha
- Department of Medicine (CJ) and Department of Research (HC, PC, MH), Central Texas Veterans Healthcare System, Temple, Texas, USA
| | - Jennifer L Cadnum
- Infectious Diseases Section (CJD) and Research Service (ALJ, JMH, JLC), Louis Stokes Cleveland Veterans Affairs Medical Center, Cleveland, Ohio, USA
| | - Curtis J Donskey
- Infectious Diseases Section (CJD) and Research Service (ALJ, JMH, JLC), Louis Stokes Cleveland Veterans Affairs Medical Center, Cleveland, Ohio, USA
| | - Philip Toltzis
- Department of Pediatrics, Rainbow Babies and Children's Hospital, Cleveland, Ohio, USA
| |
Collapse
|
2
|
Miller AC, Arakkal AT, Sewell DK, Segre AM, Pemmaraju SV, Polgreen PM. Risk for Asymptomatic Household Transmission of Clostridioides difficile Infection Associated with Recently Hospitalized Family Members. Emerg Infect Dis 2022; 28:932-939. [PMID: 35447064 PMCID: PMC9045444 DOI: 10.3201/eid2805.212023] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023] Open
Abstract
We evaluated whether hospitalized patients without diagnosed Clostridioides difficile infection (CDI) increased the risk for CDI among their family members after discharge. We used 2001–2017 US insurance claims data to compare monthly CDI incidence between persons in households with and without a family member hospitalized in the previous 60 days. CDI incidence among insurance enrollees exposed to a recently hospitalized family member was 73% greater than enrollees not exposed, and incidence increased with length of hospitalization among family members. We identified a dose-response relationship between total days of within-household hospitalization and CDI incidence rate ratio. Compared with persons whose family members were hospitalized <1 day, the incidence rate ratio increased from 1.30 (95% CI 1.19–1.41) for 1–3 days of hospitalization to 2.45 (95% CI 1.66–3.60) for >30 days of hospitalization. Asymptomatic C. difficile carriers discharged from hospitals could be a major source of community-associated CDI cases.
Collapse
|
3
|
Malvar C, Nguyen-Vu T, Shergill A, Chin YK, Baniya A, McAnanama M, Kaltenbach T, Soetikno R. The structure and delivery of a novel training course on endoscope reprocessing and standard precautions in the endoscopy unit. VideoGIE 2020; 5:176-179. [PMID: 32426562 PMCID: PMC7221475 DOI: 10.1016/j.vgie.2020.02.011] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/19/2023] Open
Affiliation(s)
- Carmel Malvar
- Section of Gastroenterology, San Francisco Veterans Affairs Medical Center, San Francisco, California.,Department of Medicine, University of California, San Francisco, California
| | - Tiffany Nguyen-Vu
- Section of Gastroenterology, San Francisco Veterans Affairs Medical Center, San Francisco, California.,Department of Medicine, University of California, San Francisco, California
| | - Amandeep Shergill
- Section of Gastroenterology, San Francisco Veterans Affairs Medical Center, San Francisco, California.,Department of Medicine, University of California, San Francisco, California
| | - Yung Ka Chin
- Department of Gastroenterology and Hepatology, Singapore General Hospital, Singapore
| | - Aruna Baniya
- Section of Gastroenterology, San Francisco Veterans Affairs Medical Center, San Francisco, California
| | - Michelle McAnanama
- Section of Gastroenterology, San Francisco Veterans Affairs Medical Center, San Francisco, California
| | - Tonya Kaltenbach
- Section of Gastroenterology, San Francisco Veterans Affairs Medical Center, San Francisco, California.,Department of Medicine, University of California, San Francisco, California.,Advanced Gastrointestinal Endoscopy, Mountain View, California
| | - Roy Soetikno
- Section of Gastroenterology, San Francisco Veterans Affairs Medical Center, San Francisco, California.,Advanced Gastrointestinal Endoscopy, Mountain View, California.,Academy of Endoscopy, Woodside, California
| |
Collapse
|