- link Copy Url - [ Share on twitter ](https://twitter.com/intent/tweet?text=Targeted Screening For C. difficile Upon Hospital Admission Could Potentially Identify Most Colonized Patients https://www.3blmedia.com/markdownify/node/36047?absolute=1&via=3blnews "link to 3 B L Media's Twitter") - [ Share on linkedin ](https://www.linkedin.com/shareArticle?mini=true&url=https://www.3blmedia.com/markdownify/node/36047?absolute=1 "link to 3 B L Media's Linkedin") - [ Share on facebook ](https://www.facebook.com/sharer/sharer.php?u=https://www.3blmedia.com/markdownify/node/36047?absolute=1 "link to 3 B L Media's Facebook") - [ email Share via email ](mailto:?subject=Targeted Screening For C. difficile Upon Hospital Admission Could Potentially Identify Most Colonized Patients&body=ESG News from Elsevier https://www.3blmedia.com/markdownify/node/36047?absolute=1 "Share via email") [Research & Policy](/CSR-News/research-policy) # Targeted Screening For C. difficile Upon Hospital Admission Could Potentially Identify Most Colonized Patients May 1, 2013 9:50 AM ET Washington, DC, May 1, 2013 /3BL Media/ – Testing patients with just three risk factors upon hospital admission has potential to identify nearly three out of four asymptomatic carriers of *C. difficile*, according to a new study published in the May issue of the [American Journal of Infection Control](http://www.ajicjournal.org/), the official publication of the Association for Professionals in Infection Control and Epidemiology ([APIC](http://www.apic.org/)). Researchers from Mayo Clinic in Rochester, MN, analyzed stool samples from 320 patients showing no symptoms of *C. difficile* at hospital admission using a real-time polymerase chain reaction (PCR) assay. Samples from 31 of 320 patients tested positive for *C. difficile*, resulting in a colonization rate of 9.7 percent. The authors wanted to estimate the reservoir of colonized patients as a source of potential transmission because despite rigorous infection control measures, *C. difficile* infection was increasing at their institution. In this study, independent predictors of *C. difficile* colonization were found to be recent hospitalization, chronic dialysis and corticosteroid use. According to the authors, one or more of the three independent risk factors were present in 155 (48 percent) of study participants, and screening only those with one or more of these factors would have identified 23 *C. difficile* carriers (74 percent). “In our population, by targeting those with identified risk factors, we would need to screen approximately half of those patients with anticipated stays longer than 24 hours, to identify three-fourths of those colonized with *C. difficile*,” said the authors. “This is in the range of previously published screening efficiency rates for MRSA.” However, the authors also state that these results should be interpreted keeping in mind that only 22 percent of all eligible patients provided stool for *C. difficile* PCR, and the study population was not representative of all patients admitted to the hospital. “Our objective was to estimate the burden of asymptomatic *C. difficile* carriers at admission because that constitutes an important checkpoint where risk factors can be assessed and infection prevention measures instituted,” said the authors. “This is the first study to demonstrate the feasibility of performing *C. difficile* surveillance on hospitalized patients at admission. The role of asymptomatic carriers in transmitting *C. difficile* should be studied further, and the utility of PCR-based targeted surveillance to detect asymptomatic carriers should be explored in areas of high endemicity or outbreak settings when other control measures have been exhausted.” “While more research needs to be conducted on the transmission of *C. difficile* infection from colonized patients, this study may help institutions with persistently high rates of transmission develop an expanded strategy for targeted *C. difficile* surveillance,” said APIC 2013 President Patti Grant, RN, BSN, MS, CIC. “The study does not indicate necessity for all healthcare facility implementation, yet provides a step-wise progressive approach to help impede *C. difficile* activity when considering the overall epidemiologic impact of transmission.” *C. difficile* causes infectious diarrhea and is linked to 14,000 American deaths each year, according to the [Centers for Disease Control and Prevention](http://www.cdc.gov/vitalsigns/hai/). While many types of healthcare-associated infections have declined in recent years, infections from *C. difficile* have increased. APIC recently issued a new open-access [Guide to Preventing C. difficile infections](http://apic.org/Professional-Practice/Implementation-guides). \# # # **Notes for Editors** “Asymptomatic *Clostridium difficile* colonization in a tertiary care hospital: Admission prevalence and risk factors,” by Surbhi Leekha, Kimberly C. Aronhalt, Lynne M. Sloan, Robin Patel and Robert Orenstein appears in the *American Journal of Infection Control*, Volume 41, Issue 5 (May 2013). **Authors:** **Surbhi Leekha, MBBS, MPH (Corresponding Author)** Division of Infectious Diseases, Mayo Clinic, Rochester, MN **Kimberly C. Aronhalt, MA, RN** Infection Prevention and Control Unit, Mayo Clinic, Rochester, MN **Lynne B. Sloan, BS** Division of Clinical Microbiology, Mayo Clinic, Rochester, MN **Robin Patel, MD** Division of Clinical Microbiology, Mayo Clinic, Rochester, MN **Robert Orenstein, DO** Division of Infectious Diseases, Mayo Clinic, Rochester, MN **About *AJIC:* *American Journal of Infection Controls*** *AJIC: American Journal of Infection Control* ([www.ajicjournal.org](http://www.ajicjournal.org/)) covers key topics and issues in infection control and epidemiology. Infection preventionists, including physicians, nurses, and epidemiologists, rely on *AJIC* for peer-reviewed articles covering clinical topics as well as original research. As the official publication of APIC, [AJIC](http://www.ajicjournal.org/) is the foremost resource on infection control, epidemiology, infectious diseases, quality management, occupational health, and disease prevention. *AJIC* also publishes infection control guidelines from APIC and the CDC. Published by [Elsevier](http://www.elsevier.com/), AJIC is included in MEDLINE and CINAHL. **About APIC** [APIC](http://www.apic.org/)’s mission is to create a safer world through prevention of infection. The association’s more than 14,000 members direct infection prevention programs that save lives and improve the bottom line for hospitals and other healthcare facilities. APIC advances its mission through patient safety, implementation science, competencies and certification, advocacy, and data standardization. Visit APIC online at [www.apic.org](https://mail.apic.org/exchweb/bin/redir.asp?URL=https://mail.apic.org/exchweb/bin/redir.asp?URL=http://www.apic.org/ "https://mail.apic.org/exchweb/bin/redir.asp?URL=https://mail.apic.org/exchweb/bin/redir.asp?URL=http://www.apic.org/"). Follow APIC on Twitter: . **About Elsevier** Elsevier is a world-leading provider of scientific, technical and medical information products and services. The company works in partnership with the global science and health communities to publish more than 2,000 journals, including [*The Lancet*](http://www.thelancet.com/) and [*Cell*](http://www.cell.com/), and close to 20,000 book titles, including major reference works from Mosby and Saunders. Elsevier’s online solutions include [ScienceDirect](http://www.sciencedirect.com/), [Scopus](http://www.scopus.com/), [Reaxys](http://www.elsevier.com/reaxys), [ClinicalKey](https://www.clinicalkey.com/) and [Mosby’s Suite](http://www.confidenceconnected.com/), which enhance the productivity of science and health professionals, and the [SciVal suite](http://www.scival.com/) and [MEDai’s Pinpoint Review](http://www.medai.com/), which help research and health care institutions deliver better outcomes more cost-effectively. A global business headquartered in Amsterdam, [Elsevier](http://www.elsevier.com/) employs 7,000 people worldwide. 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Their shares are traded on the London, Amsterdam and New York Stock Exchanges using the following ticker symbols: London: REL; Amsterdam: REN; New York: RUK and ENL. **Media contact** Liz Garman +1 202 454 2604 [![](/sites/default/files/Clients/elsevier_1.jpg)](/profiles/elsevier) ### More from Elsevier ###### [Middle East Respiratory Syndrome Coronavirus Unlikely to Reach Epidemic Status](/news/middle-east-respiratory-syndrome-coronavirus-unlikely-reach-epidemic-status) Dec 15, 2014 9:00 AM ET ###### [Health Care Lessons Learned in the Aftermath of September 11, 2001](/news/health-care-lessons-learned-aftermath-september-11-2001) Dec 10, 2014 10:00 AM ET ###### [Guidelines for Treatment of Ebola Patients Are Urgently Needed](/news/guidelines-treatment-ebola-patients-are-urgently-needed) Dec 10, 2014 9:00 AM ET ###### [Asbestos: An Ongoing Challenge to Global Health](/news/asbestos-ongoing-challenge-global-health) Dec 9, 2014 9:00 AM ET ###### [Chemotherapy Can Complicate Immediate Breast Reconstruction After Mastectomy](/news/chemotherapy-can-complicate-immediate-breast-reconstruction-after-mastectomy) Dec 3, 2014 10:00 AM ET ###### [New Study Strengthens Evidence of the Connection Between Statin Use and Cataracts; But Any Risks Should be Weighed Against Benefits](/news/new-study-strengthens-evidence-connection-between-statin-use-and-cataracts-any-risks-should-be) Dec 3, 2014 9:00 AM ET ###### [Prognostic Role Found for miR-21 Expression in Triple-Negative Breast Cancer](/news/prognostic-role-found-mir-21-expression-triple-negative-breast-cancer) Dec 2, 2014 11:00 AM ET ###### [Lapses in Infection Control Associated with Spread of Severe Respiratory Virus MERS, According to Study ](/news/lapses-infection-control-associated-spread-severe-respiratory-virus-mers-according-study) Dec 2, 2014 10:40 AM ET