Healix Infusion Therapy, LLC, 14140 Southwest Freeway, Suite 400, Sugar Land, TX, 77478, USA.
Atlanta ID Group, 275 Collier Rd, Suite 450, Atlanta, GA, 30309, USA.
Anaerobe. 2022 Oct;77:102617. doi: 10.1016/j.anaerobe.2022.102617. Epub 2022 Aug 6.
Patients with Clostridioides difficile infection (CDI) who receive treatment at outpatient infusion centers (OICs) pose a risk for spore transmission. We investigated C. difficile contamination in the environment of CDI and non-CDI patients and evaluated the effectiveness of standard cleaning.
This is a multicenter, non-conventional study including 8 OICs between October 2019 and December 2020. Samples were collected at baseline, after infusion, and after cleaning CDI and non-CDI areas. Cleaning was performed using hypochlorite and non-hypochlorite products for CDI and non-CDI, respectively. Samples were cultured for toxigenic C. difficile and strain-typed via fluorescent PCR ribotyping and whole-genome sequencing.
The overall C. difficile contamination rate was 7.9% (156/1969) with 8.1% in patient and 5.6% in non-patient care areas, respectively. For CDI areas, contamination rates were 5.9% at baseline, 15.0% after infusion, and significantly reduced to 6.2% after cleaning (P = 0.004). For non-CDI areas, contamination was similar at baseline (9.5%), after infusion (7.6%), and after cleaning (4.3%). The difference in C. difficile-positive samples after infusion was significant for CDI vs. non-CDI (15.0% vs. 7.6%, P = 0.004). Overall contamination was 11.5% for floors, 7.9% for infusion chairs, and 3.8% for equipment (P = 0.001). The most frequent ribotypes were F014-020 (42.6%), F106 (15.6%), F255 (6.1%), F001 (5.2%) and F027 (3.5%). Cleaning resulted in elimination of F106, F255, F001, F027 and partial reduction of F014-020.
Environmental C. difficile contamination was increased after CDI infusions and significantly reduced after cleaning with a hypochlorite solution, reducing the potential risk of spore transmission to others.
在门诊输液中心（OIC）接受治疗的艰难梭菌感染（CDI）患者存在孢子传播的风险。我们调查了 CDI 和非 CDI 患者环境中的艰难梭菌污染情况，并评估了标准清洁的效果。
这是一项多中心、非常规研究，包括 2019 年 10 月至 2020 年 12 月期间的 8 个 OIC。在基线、输液后以及清洁 CDI 和非 CDI 区域后采集样本。分别使用含氯和非含氯产品清洁 CDI 和非 CDI 区域。通过荧光 PCR 核糖体分型和全基因组测序培养样本以检测产毒艰难梭菌并对其进行菌株分型。
艰难梭菌的总体污染率为 7.9%（156/1969），患者区域为 8.1%，非患者护理区域为 5.6%。对于 CDI 区域，基线时的污染率为 5.9%，输液后为 15.0%，经清洁后显著降低至 6.2%（P=0.004）。对于非 CDI 区域，基线时（9.5%）、输液后（7.6%）和清洁后（4.3%）的污染情况相似。CDI 与非 CDI 之间输注后艰难梭菌阳性样本的差异具有统计学意义（15.0%比 7.6%，P=0.004）。地板的总体污染率为 11.5%，输液椅为 7.9%，设备为 3.8%（P=0.001）。最常见的核糖体型为 F014-020（42.6%）、F106（15.6%）、F255（6.1%）、F001（5.2%）和 F027（3.5%）。清洁后，F106、F255、F001、F027 被消除，F014-020 部分减少。
CDI 输液后环境中艰难梭菌的污染增加，用含氯溶液清洁后显著减少，降低了向他人传播孢子的潜在风险。
