<i>Clostridium difficile</i>environmental contamination within a clinical laundry facility in the USA

Michael, Karen; No, David; Dankoff, Jennifer; Lee, Kyoyi; Lara-Crawford, Elisabeth; Roberts, Marilyn C.

doi:10.1093/femsle/fnw236

Cited by 10 publications

(13 citation statements)

References 31 publications

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“…Therefore we proposed a low genetic diversity of toxigenic strains in Isfahan, Iran. Other similar studies in Europe, the Middle East, and North America previously identified ST2 as a common clinical strain all around the world [29]. Studies performed in China and France showed various STs in A − B + strains, yet the most prevalent STs were ST-2, ST-54, ST-37, and ST-35 in China and ST-1 in France.…”

Section: Discussionmentioning

confidence: 76%

Molecular epidemiology of Clostridium difficile infection in Iranian hospitals

Shoaei

Shojaei

Khorvash

et al. 2019

Antimicrob Resist Infect Control

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BackgroundClostridium difficile infection (CDI) is known as one of the most important causes of nosocomial infections. The main objective of this study was to evaluate the presence of Clostridium difficile in the stool of hospitalized patients with diarrhea as well as in their environments.MethodsC. difficile isolates were characterized according to the presence of toxin genes and antibiotic resistance. Multilocus Sequence Typing Analysis (MLST) was applied for finding the genetic polymorphism and relationship among strain lineages.ResultsA total of 821 samples (574 stools and 247 swabs) were collected between April 2015 and May 2017. The prevalence of C. difficile isolates was 28.6% (164/574) in patients and 19% (47/247) in swabs taken from medical devices, hands of healthcare workers and skin patient sites. Finally, 11.5% (66/574) toxigenic C. difficile strains isolated from stool samples of inpatients and 4.4% (11/247) from hands of healthcare workers and skin patient sites. All the toxigenic isolates were inhibited by a low concentration of vancomycin (MIC < 0.5 μg/ml). About 43% (33/77) and 39% of isolates were resistant to Clindamycin and moxifloxacin respectively. All isolates were susceptible to metronidazole. Toxigenic C. difficile strains were analyzed by MLST and were divided into 4 different STs. The detected types were ST-54 (57.9%), followed by ST-2 (31.6. %), ST-15 (5.3%) and ST-37 (5.3%), while none of the isolates were identified as ST-1 or ST-11. Significant risk factors for CDI appear to be advanced age, undergoing chemotherapy, previous surgery, and residence in the nursing home.ConclusionsCDI is common in Iran and further studies are recommended to monitor its epidemiological variations. Moreover, greater attempts must be made to encourage antibiotic stewardship by healthcare workers and the public.

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Section: Discussionmentioning

confidence: 76%

Molecular epidemiology of Clostridium difficile infection in Iranian hospitals

Shoaei

Shojaei

Khorvash

et al. 2019

Antimicrob Resist Infect Control

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“…1A), being the coexistence event 3 caused by Clade-1 and Clade-2 STs. Two of these events were identified from CO samples (events 2 and 3) and ST-8 was the only ST that was present consistently in all the events, which could be due to its widely reported frequency 25 . Although in Colombia typing schemes have been applied to a small number of isolates of C .…”

Section: Discussionmentioning

confidence: 93%

Integrated genomic epidemiology and phenotypic profiling of Clostridium difficile across intra-hospital and community populations in Colombia

Muñoz

Restrepo-Montoya

Kumar

et al. 2019

Sci Rep

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Clostridium difficile , the causal agent of antibiotic-associated diarrhea, has a complex epidemiology poorly studied in Latin America. We performed a robust genomic and phenotypic profiling of 53 C . difficile clinical isolates established from diarrheal samples from either intrahospital (IH) or community (CO) populations in central Colombia. In vitro tests were conducted to evaluate the cytopathic effect, the minimum inhibitory concentration of ten antimicrobial agents, the sporulation efficiency and the colony forming ability. Eleven different sequence types (STs) were found, the majority present individually in each sample, however in three samples two different STs were isolated. Interestingly, CO patients were infected with STs associated with hypervirulent strains (ST-1 in Clade-2). Three coexistence events (two STs simultaneously detected in the same sample) were observed always involving ST-8 from Clade-1. A total of 2,502 genes were present in 99% of the isolates with 95% of identity or more, it represents a core genome of 28.6% of the 8,735 total genes identified in the set of genomes. A high cytopathic effect was observed for the isolates positive for the two main toxins but negative for binary toxin (TcdA+/TcdB+/CDT− toxin production type), found only in Clade-1. Molecular markers conferring resistance to fluoroquinolones ( cdeA and gyrA ) and to sulfonamides ( folP ) were the most frequent in the analyzed genomes. In addition, 15 other markers were found mostly in Clade-2 isolates. These results highlight the regional differences that C . difficile isolates display, being in this case the CO isolates the ones having a greater number of accessory genes and virulence-associated factors.

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“…Also, handling dirty clothes and then sorting washed clothes can result in cross-contamination. This crosscontamination web has been reported in commercial laundries (41,42). Furthermore, on May 24, 2021 by guest http://aem.asm.org/ Downloaded from storage of the clothing can result in growth of bacteria and molds under humid conditions (28).…”

Section: Laundry Processingmentioning

confidence: 63%

Laundry Hygiene and Odor Control: State of the Science

Abney

Ijaz

McKinney

et al. 2021

Appl Environ Microbiol

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Laundering of textiles – clothing, linens, cleaning cloths - functionally removes dirt and bodily fluids which, prevent the transmission and re-exposure to pathogens as well as odor control. Thus, proper laundering is key to controlling microbes that cause illness and produce odors. The practice of laundering varies from region to region and is influenced by culture and resources. This review aims to define laundering as a series of steps that influence the exposure of the person processing the laundry to pathogens – with respect to the removal and control of pathogens and odor causing bacteria, while taking into consideration the types of textiles. Defining laundering in this manner will help better educate the consumer, highlight areas where more research is needed, and how to maximize products and resources. Control of microorganisms during laundering involves mechanical (agitation, soaking), chemical (detergent, bleach), and physical processes (detergent, temperature). Temperature plays the most important role in terms of pathogen control, requiring temperatures exceeding 40°C to 60°C for proper inactivation. While detergents play a role in reducing the microbial load of laundering through release of microbes attached to fabrics and inactivation of microbes sensitive to detergents (e.g. enveloped viruses). The use of additives (enzymes) and bleach (chlorine, activated oxygen) become essential in washes with temperatures below 20°C, especially for certain enteric viruses and bacteria. A structured approach is needed which identifies all the steps in the laundering process and attempts to identify each step relative to its importance to infection risk and odor production.

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Clostridium difficileenvironmental contamination within a clinical laundry facility in the USA

Cited by 10 publications

References 31 publications

Molecular epidemiology of Clostridium difficile infection in Iranian hospitals

Molecular epidemiology of Clostridium difficile infection in Iranian hospitals

Integrated genomic epidemiology and phenotypic profiling of Clostridium difficile across intra-hospital and community populations in Colombia

Laundry Hygiene and Odor Control: State of the Science

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