Risk for Asymptomatic Household Transmission of Clostridioides difficile Infection Associated with Recently Hospitalized Family Members

Abstract

C lostridioides difficile infection (CDI) is one of the most commonly occurring types of healthcareassociated infection and is predominately associated with hospitals (1,2). Thus, CDI-related investigations and interventions primarily have focused on hospital settings. More recently, reports of community-associated CDI cases, in which patients without a history of recent hospitalization are infected, have become more common (3,4). Although healthcare-associated CDI remains a considerable problem, more emphasis on community-associated CDI cases also is needed.Risk factors for community-associated CDI are similar to risk factors for hospital-associated cases.

Infrequent intrahousehold transmission of Clostridioides difficile between pet owners and their pets

“…In this study, we found that pets of patients with C. difficile infec- to human-to-human transmission (Miller et al, 2022). Results from other epidemiological studies corroborate our findings.…”

“…Taken together, these findings suggest that transmission occurred from people to animals. Because patients with CDI can persistently shed C. difficile even following resolution of diarrhoea (Jury et al, 2013;Sethi et al, 2010) and infect human household contacts (Miller et al, 2022)…”

“…The source of these community‐acquired infections has not been clearly established. People asymptomatically colonized or infected with C. difficile are potential reservoirs (Galdys et al, 2014; Miller et al, 2022), but zoonotic, environmental and food‐borne transmission of C. difficile to people has also been suggested (Knetsch et al, 2014; Knetsch et al, 2018; Varshney et al, 2014).…”

Molecular epidemiology of community‐ and hospital‐associated Clostridioides difficile infections in Jönköping, Sweden, October 2017 – March 2018

“…Also, the transmission was most likely occurring within the household after discharge and not during short‐time visits of family members to the hospital. While it remains crucial to identify reservoirs in the community or healthcare facilities to implement health hygiene measures that can prevent further CDI cases including asymptomatic transmission and transmission in outpatient care (35,36), we believe that short‐time visits that lasts a few hours pose a low risk for CDI, and that errors in our classification of CA‐ and HA‐cases were low. Despite the abovementioned limitations, our study gives an indication about the molecular epidemiology of HA‐ and CA‐CDIs.…”

“…Although C. difficile spores can be present in the hospital environment and asymptomatic colonization of C. difficile among staff and patients may occur, the risk of acquiring CDI is clearly related to the length of hospital stay ( 33 , 34 ). A recent report found an increased risk for CDI in family members of discharged hospitalized patients without diagnosed CDI ( 35 ). The relative risk increased from 1.30 for 1–3 days of hospital stay to 2.45 for >30 days of stay.…”