Environment Plays Significant Role in C. diff Acquisition

In a commentary in Infection Control and Hospital Epidemiology, David J. Weber, MD, MPH, of the Department of Medicine, University of North Carolina at Chapel Hill and William A. Rutala, PhD, MPH, of the Department of Hospital Epidemiology at UNC Health Care in Chapel Hill, N.C. note that, "The epidemiologic evidence strongly supports an important role for environmental contamination in the acquisition of C. difficile infection in healthcare facilities" even though in the past "The major mechanism of transmission of healthcare-associated pathogens among patients has been thought to be patient-to-patient transmission via the hands of healthcare providers."

Weber and Rutala add, "Over the past decade, there has been a growing appreciation that environmental contamination makes an important contribution to hospital-acquired infection with MRSA and vancomycin-resistant enterococcus (VRE). More recently, environmental contamination has been demonstrated to play an important role in acquisition of infection with C. difficile, norovirus and Acinetobacter species."

The researchers point to various new technologies currently inthe marketplace (such as vaporized hydrogen peroxide and ultraviolet light) and say that the best method for environmental control of multidrug-resistant organisms has not been determined. They add, "Specifically, whether the use of a sporicidal agent for daily room disinfection or at terminal cleaning would reduce CDI incidence in hospitals has not been evaluated. New technologies... hold promise in reducing the incidence of CDI, but additional studies are warranted."

Reference: Weber DJ and Rutala WA. The Role of the Environment in Transmission of Clostridium difficile Infection in Healthcare Facilities. Infect Control Hosp Epidem. Vol. 32, No. 3. March 2011.