Outbreak of Clostridium difficile ribotype 027 in a residential home

Clayton, James; McHale-Owen, J.

doi:10.1016/j.jhin.2014.09.007

Cited by 4 publications

(1 citation statement)

References 3 publications

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“…Selective decontamination of the digestive tract in ICU patients (using oropharyngeal and intestinal applications of colistin, tobramycin and amphotericin in combination with systemic cefotaxime during the first two to four days) during an outbreak also increased CDI risk [19]. Information campaigns to medical personnel were key in several reports [16,20,21,23]. Most reports, however, stressed reinforcing hand hygiene, some also by the affected patients themselves, and wearing gloves and gowns [18e21].…”

Section: Discussionmentioning

confidence: 99%

Successful management of a Clostridioides difficile ribotype 027 outbreak with a lean intervention bundle

Kuenzli

Casanova

Sommerstein

et al. 2020

Journal of Hospital Infection

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Background: In a 2015 point-prevalence study, Clostridioides difficile 027, a hypervirulent ribotype, was absent from healthcare institutions in Switzerland. In late 2016, we detected an outbreak of C. difficile infection (CDI) with ribotype 027 occurring across several hospitals in the same hospital network. Methods: The first cases of CDI due to ribotype 027 triggered an outbreak investigation, including whole genome sequencing (WGS) to identify outbreak strains. Findings: Twenty-eight patients with CDI caused by ribotype 027 between December 2016 and December 2017 were identified, out of which 20 were caused by a single clone. Commonalities among these patients were hospitalization in the same room or on the same ward, receiving care from the same healthcare workers, and shared toilet areas. In addition to the epidemiological links suggesting possible transmission pathways between cases, WGS confirmed the clonality of this C. difficile 027 outbreak. The outbreak was contained by isolation precautions, raising awareness among healthcare workers, harmonizing diagnostic algorithms, and switching to a sporicidal agent for environmental disinfection. Of note, neither default gowning and gloving nor hand washing with water and soap were implemented. Conclusion: This C. difficile 027 outbreak was recognized belatedly due to lack of screening for this ribotype in some hospitals, and was contained by a swift response with simple infection prevention measures and adapting the laboratory approach. In order to have a better understanding of C. difficile epidemiology, diagnostic approaches should be standardized, CDI declared notifiable, and longitudinal data on prevalent ribotypes collected in countries where this is not established.

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Section: Discussionmentioning

confidence: 99%

Successful management of a Clostridioides difficile ribotype 027 outbreak with a lean intervention bundle

Kuenzli

Casanova

Sommerstein

et al. 2020

Journal of Hospital Infection

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Low prevalence of Clostridium difficile colonization in patients in long-term care facilities in Graz, Austria: A point-prevalence study

Leitner

Schreiner

Neuhold

et al. 2020

American Journal of Infection Control

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Healthcare-associated infections and infection control

Astagneau¹,

Seringe²,

Bricaire³

2017

Oxford Textbook of Geriatric Medicine

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Healthcare-associated infections (HAI) in older people frequently occur in mid or long-term cares facilities. The most frequent infections are those of the urinary tract, respiratory tract, skin/soft tissue, and gastrointestinal tract. The spectrum of pathogens are different in epidemic and endemic situations. Outbreaks occurring in long-term care frequently involve seasonal viruses such influenza, scabies, and multidrug-resistant bacteria such as Clostridium difficile. Ageing is a risk factor for HAI, which impairs immunological, metabolical, and neurological functions. Indwelling devices, poor nutritional status, and lack of mobility also increase the infection risk in the cared-for elderly. Infection control measures have to be implemented according to standard recommendations, including the use of alcohol-based hand rubs. Control measures should be adapted to the organization of healthcare facilites for older people, in particular environment and poor staff ressources. Focus should be made on vaccination programme of healthcare staff, especially against influenza.

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Outbreak of Clostridium difficile ribotype 027 in a residential home

Cited by 4 publications

References 3 publications

Successful management of a Clostridioides difficile ribotype 027 outbreak with a lean intervention bundle

Successful management of a Clostridioides difficile ribotype 027 outbreak with a lean intervention bundle

Low prevalence of Clostridium difficile colonization in patients in long-term care facilities in Graz, Austria: A point-prevalence study

Healthcare-associated infections and infection control

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