The Hospital Environment as a Potential Source for Clostridioides difficile Transmission Based on Spore Detection Surveys Conducted at Paediatric Oncology and Gastroenterology Units

Ewelina Lemiech-Mirowska (), Michał Michałkiewicz, Aleksandra Sierocka, Ewelina Gaszyńska and Michał Marczak
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Ewelina Lemiech-Mirowska: Department of Management and Logistics in Healthcare, Medical University of Lodz, 90-419 Lodz, Poland
Michał Michałkiewicz: Institute of Environmental Engineering and Building Installations, Faculty of Environmental Engineering and Energy, Poznan University of Technology, 60-965 Poznan, Poland
Aleksandra Sierocka: Department of Management and Logistics in Healthcare, Medical University of Lodz, 90-419 Lodz, Poland
Ewelina Gaszyńska: Department of Nutrition and Epidemiology, Medical University of Lodz, 90-419 Lodz, Poland
Michał Marczak: Department of Management and Logistics in Healthcare, Medical University of Lodz, 90-419 Lodz, Poland

IJERPH, 2023, vol. 20, issue 2, 1-12

Abstract: Clostridioides difficile is an anaerobic, Gram-positive bacterium widely present in the hospital environment due to its ability to generate spores. The transfer of spores to patients through the hands of medical personnel is one of the most frequent paths of C. difficile transmission. In paediatric patients burdened with a serious primary illness requiring long-term hospitalisation and antibiotic therapy, C. difficile may be a significant risk factor for antibiotic-associated diarrhoea. The goal of the study was to assess the state of hospital environments as a potential source of C. difficile spores and to establish the share of hyperepidemic strains at the two paediatric units. The survey for C. difficile was conducted with a C. diff Banana Broth TM medium, used to detect spores and to recover vegetative forms of the bacteria. Environmental samples ( n = 86) and swabs from the clothing of medical personnel ( n = 14) were collected at two units of a paediatric hospital, where the cases of antibiotic-associated diarrhoea with a C. difficile aetiology constitute a significant clinical problem. In 17 samples, a change in the broth’s colour was observed, indicating the presence of spores. Out of seven samples, C. difficile strains were cultured. The pathogenic isolates of C. difficile were obtained from swabs collected from elements of beds, a toilet, a door handle and a doctor’s uniform. In our study, we indicated points of increased risk of pathogen transmission, which could constitute a source of infection. The clothing of medical personnel may be a dangerous carrier of pathogenic spores. Periodical surveys of hospital environments with the use of specialist microbiological mediums successfully indicate the direction of corrective actions to be undertaken by the medical facility in order to increase patient safety.

Keywords: C. difficile; C. diff Banana Broth TM; paediatric hospital; spores; environmental sampling; medical personnel uniform (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2023
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