Emerg Infect Dis. 2024 May;30(5):908-915. doi: 10.3201/eid3005.231588.
Considering patient room shortages and prevalence of other communicable diseases, reassessing the isolation of patients with Clostridioides difficile infection (CDI) is imperative. We conducted a retrospective study to investigate the secondary CDI transmission rate in a hospital in South Korea, where patients with CDI were not isolated. Using data from a real-time locating system and electronic medical records, we investigated patients who had both direct and indirect contact with CDI index patients. The primary outcome was secondary CDI transmission, identified by whole-genome sequencing. Among 909 direct and 2,711 indirect contact cases, 2 instances of secondary transmission were observed (2 [0.05%] of 3,620 cases), 1 transmission via direct contact and 1 via environmental sources. A low level of direct contact (113 minutes) was required for secondary CDI transmission. Our findings support the adoption of exhaustive standard preventive measures, including environmental decontamination, rather than contact isolation of CDI patients in nonoutbreak settings.
考虑到患者病房短缺和其他传染病的流行，重新评估艰难梭菌感染（CDI）患者的隔离措施势在必行。我们进行了一项回顾性研究，以调查韩国一家医院的 CDI 二次传播率，该医院的 CDI 患者并未进行隔离。我们使用实时定位系统和电子病历的数据，调查了与 CDI 指数患者有直接和间接接触的患者。主要结局是通过全基因组测序确定的二次 CDI 传播。在 909 例直接接触和 2711 例间接接触病例中，观察到 2 例二次传播（3620 例中有 2 例[0.05%]），1 例通过直接接触传播，1 例通过环境源传播。需要进行低水平的直接接触（113 分钟）才能发生二次 CDI 传播。我们的研究结果支持在非暴发情况下采用全面的标准预防措施，包括环境去污，而不是对 CDI 患者进行接触隔离。
