Ingrid Jullian-Desayes1, Caroline Landelle2, Marie-Reine Mallaret3, Christian Brun-Buisson4, Frédéric Barbut5. 1. Infection Control Unit, Centre Hospitalier Universitaire Grenoble Alpes, Université de Grenoble, Grenoble, France. 2. Infection Control Unit, Centre Hospitalier Universitaire Grenoble Alpes, Université de Grenoble, Grenoble, France; University Grenoble Alpes/CNRS, ThEMAS TIM-C UMR 5525, Grenoble, France. Electronic address: caroline.landelle@gmail.com. 3. Infection Control Unit, Centre Hospitalier Universitaire Grenoble Alpes, Université de Grenoble, Grenoble, France; University Grenoble Alpes/CNRS, ThEMAS TIM-C UMR 5525, Grenoble, France. 4. Infection Control Unit, Centre Hospitalier Universitaire Albert Chenevier-Henri Mondor, Assistance Publique-Hôpitaux de Paris, Université Paris-Est Créteil, Paris, France; Medical Intensive Care Unit, Centre Hospitalier Universitaire Albert Chenevier-Henri Mondor, Assistance Publique-Hôpitaux de Paris, Université Paris-Est Créteil, Paris, France. 5. National Reference Laboratory for Clostridium difficile, Hôpital Saint-Antoine, Assistance Publique-Hôpitaux de Paris, Groupe de recherche clinique EPIDIFF, Université Pierre et Marie Curie, Paris, France.
Abstract
BACKGROUND: Clostridium difficile infection (CDI) can be transmitted from patient to patient by the hands of health care workers (HCWs); however, the relative importance of this route in the spread of C difficile in the hospital is currently unknown. Our aim was to review studies examining HCWs' hand carriage and its potential role in CDI transmission. METHODS: First, English-speaking references addressing HCWs' hand sampling obtained from the PubMed database were reviewed. Second, C difficile outbreaks definitely or probably implicating HCWs were retrieved from the Outbreak Database Web site (www.outbreak-database.com). Finally, cases of C difficile occurring in HCWs after contact with an infected patient were retrieved from PubMed. RESULTS: A total of 11 studies dealing with HCWs' hand carriage were selected and reviewed. Between 0% and 59% of HCWs' hands were found contaminated with C difficile after caring for a patient with CDI. There were several differences between studies regarding site of hands sampling, timing after contact, and bacteriologic methods. Only 2 C difficile outbreaks implicating HCWs and 6 series of cases of transmission from patients to HCWs have been reported. CONCLUSIONS: This review shows that HCWs' hands could play an important role in the transmission of C difficile. Hand hygiene and reduction of environmental contamination are essential to control C difficile transmission.
BACKGROUND:Clostridium difficileinfection (CDI) can be transmitted from patient to patient by the hands of health care workers (HCWs); however, the relative importance of this route in the spread of C difficile in the hospital is currently unknown. Our aim was to review studies examining HCWs' hand carriage and its potential role in CDI transmission. METHODS: First, English-speaking references addressing HCWs' hand sampling obtained from the PubMed database were reviewed. Second, C difficile outbreaks definitely or probably implicating HCWs were retrieved from the Outbreak Database Web site (www.outbreak-database.com). Finally, cases of C difficile occurring in HCWs after contact with an infected patient were retrieved from PubMed. RESULTS: A total of 11 studies dealing with HCWs' hand carriage were selected and reviewed. Between 0% and 59% of HCWs' hands were found contaminated with C difficile after caring for a patient with CDI. There were several differences between studies regarding site of hands sampling, timing after contact, and bacteriologic methods. Only 2 C difficile outbreaks implicating HCWs and 6 series of cases of transmission from patients to HCWs have been reported. CONCLUSIONS: This review shows that HCWs' hands could play an important role in the transmission of C difficile. Hand hygiene and reduction of environmental contamination are essential to control C difficile transmission.
Authors: Anutthaman Parthasarathy; Narayan H Wong; Amanda N Weiss; Susan Tian; Sara E Ali; Nicole T Cavanaugh; Tyler M Chinsky; Chelsea E Cramer; Aditya Gupta; Rakshanda Jha; Loryn K Johnson; Elizabeth D Tuason; Lauren M Klafehn; Varada Krishnadas; Ryan J Musich; Jennifer M Pfaff; Spencer C Richman; Alexandria J Shumway; André O Hudson Journal: J Genomics Date: 2019-02-19