Screening for Asymptomatic Clostridioides difficile Carriage Among Hospitalized Patients: A Narrative Review
Abstract Clostridioides difficile infection (CDI) has become the most common healthcare-associated infection in the United States, with considerable morbidity, mortality, and healthcare costs. Assessing new preventive strategies is vital. We present a literature review of studies evaluating a strate...
| Main Authors: | , , , , |
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| Format: | Article |
| Language: | English |
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Adis, Springer Healthcare
2023-09-01
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| Series: | Infectious Diseases and Therapy |
| Subjects: | |
| Online Access: | https://doi.org/10.1007/s40121-023-00856-4 |
| _version_ | 1797653571940909056 |
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| author | Mayan Gilboa Nadav Baharav Eyal Melzer Gili Regev-Yochay Dafna Yahav |
| author_facet | Mayan Gilboa Nadav Baharav Eyal Melzer Gili Regev-Yochay Dafna Yahav |
| author_sort | Mayan Gilboa |
| collection | DOAJ |
| description | Abstract Clostridioides difficile infection (CDI) has become the most common healthcare-associated infection in the United States, with considerable morbidity, mortality, and healthcare costs. Assessing new preventive strategies is vital. We present a literature review of studies evaluating a strategy of screening and isolation of asymptomatic carriers in hospital settings. Asymptomatic detection of C. difficile is reported in ~ 10–20% of admitted patients. Risk factors for carriage include recent hospitalization, previous antibiotics, older age, lower functional capacity, immunosuppression, and others. Asymptomatic C. difficile carriers of toxigenic strains are at higher risk for progression to CDI. They are also shedders of C. difficile spores and may contribute to the persistence and transmission of this bacterium. Screening for asymptomatic carriers at hospital admission can theoretically reduce CDI by isolating carriers to reduce transmission, and implementing antibiotic stewardship measures targeting carriers to prevent progression to clinical illness. Several observational studies, summarized in this review, have reported implementing screening and isolation strategies, and found a reduction in CDI rates. Nevertheless, the data are still limited to a few observational studies, and this strategy is not commonly practiced. Studies supporting screening were performed in North America, coinciding with the period of dominance of the 027/BI/NAP1 strain. Additional studies evaluating screening, followed by infection control and antibiotic stewardship measures, are needed. |
| first_indexed | 2024-03-11T16:46:32Z |
| format | Article |
| id | doaj.art-af1ab224a5a249b1a07b83610c763473 |
| institution | Directory Open Access Journal |
| issn | 2193-8229 2193-6382 |
| language | English |
| last_indexed | 2024-03-11T16:46:32Z |
| publishDate | 2023-09-01 |
| publisher | Adis, Springer Healthcare |
| record_format | Article |
| series | Infectious Diseases and Therapy |
| spelling | doaj.art-af1ab224a5a249b1a07b83610c7634732023-10-22T11:23:09ZengAdis, Springer HealthcareInfectious Diseases and Therapy2193-82292193-63822023-09-011292223224010.1007/s40121-023-00856-4Screening for Asymptomatic Clostridioides difficile Carriage Among Hospitalized Patients: A Narrative ReviewMayan Gilboa0Nadav Baharav1Eyal Melzer2Gili Regev-Yochay3Dafna Yahav4Infection Prevention Unit, Sheba Medical CenterInfectious Diseases Unit, Sheba Medical CenterInfection Prevention Unit, Sheba Medical CenterInfection Prevention Unit, Sheba Medical CenterFaculty of Medicine, Tel Aviv UniversityAbstract Clostridioides difficile infection (CDI) has become the most common healthcare-associated infection in the United States, with considerable morbidity, mortality, and healthcare costs. Assessing new preventive strategies is vital. We present a literature review of studies evaluating a strategy of screening and isolation of asymptomatic carriers in hospital settings. Asymptomatic detection of C. difficile is reported in ~ 10–20% of admitted patients. Risk factors for carriage include recent hospitalization, previous antibiotics, older age, lower functional capacity, immunosuppression, and others. Asymptomatic C. difficile carriers of toxigenic strains are at higher risk for progression to CDI. They are also shedders of C. difficile spores and may contribute to the persistence and transmission of this bacterium. Screening for asymptomatic carriers at hospital admission can theoretically reduce CDI by isolating carriers to reduce transmission, and implementing antibiotic stewardship measures targeting carriers to prevent progression to clinical illness. Several observational studies, summarized in this review, have reported implementing screening and isolation strategies, and found a reduction in CDI rates. Nevertheless, the data are still limited to a few observational studies, and this strategy is not commonly practiced. Studies supporting screening were performed in North America, coinciding with the period of dominance of the 027/BI/NAP1 strain. Additional studies evaluating screening, followed by infection control and antibiotic stewardship measures, are needed.https://doi.org/10.1007/s40121-023-00856-4Clostridioides difficileScreeningInfection controlContact isolationAntibiotic stewardship |
| spellingShingle | Mayan Gilboa Nadav Baharav Eyal Melzer Gili Regev-Yochay Dafna Yahav Screening for Asymptomatic Clostridioides difficile Carriage Among Hospitalized Patients: A Narrative Review Infectious Diseases and Therapy Clostridioides difficile Screening Infection control Contact isolation Antibiotic stewardship |
| title | Screening for Asymptomatic Clostridioides difficile Carriage Among Hospitalized Patients: A Narrative Review |
| title_full | Screening for Asymptomatic Clostridioides difficile Carriage Among Hospitalized Patients: A Narrative Review |
| title_fullStr | Screening for Asymptomatic Clostridioides difficile Carriage Among Hospitalized Patients: A Narrative Review |
| title_full_unstemmed | Screening for Asymptomatic Clostridioides difficile Carriage Among Hospitalized Patients: A Narrative Review |
| title_short | Screening for Asymptomatic Clostridioides difficile Carriage Among Hospitalized Patients: A Narrative Review |
| title_sort | screening for asymptomatic clostridioides difficile carriage among hospitalized patients a narrative review |
| topic | Clostridioides difficile Screening Infection control Contact isolation Antibiotic stewardship |
| url | https://doi.org/10.1007/s40121-023-00856-4 |
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