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Unexpected Origin of Hospital Infections

The intestinal bacterium Clostridium difficile can be lethal and is difficult to treat. Each year it sickens about half a million Americans and causes about 30,000 deaths. C. diff, as it’s called, has long been thought to infect people hospitalized or in other healthcare facilities. But in a study published in December 2019 in Infection Control and Hospital Epidemiology, researchers report that nearly one in 10 patients admitted to the hospital is already infected with C. diff, even though they do not have symptoms.

The researchers, led by Sarah Baron, M.D., M.S., tested 220 incoming hospital patients with no symptoms of C. diff and found that 21 were infected. Within six months, 38% of those carriers progressed to symptomatic C. diff; by contrast, only 2% of initially noninfected patients ended up with symptomatic C. diff.

The U.S. Centers for Disease Control and Prevention considers the prospective identification of C. diff carriers a “supplemental intervention” but doesn’t recommend it as a prevention strategy. This study suggests that prospectively identifying and treating carriers could help prevent C. diff–related illnesses and deaths. Dr. Baron is an assistant professor of medicine at Einstein and director of inpatient quality improvement in the department of medicine at Montefiore.

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