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Volume 27, Number 7—July 2021
Synopsis

Risks and Preventive Strategies for Clostridioides difficile Transmission to Household or Community Contacts during Transition in Healthcare Settings

Ramin AsgaryComments to Author , Jessica A. Snead, Nabeel A. Wahid, Vicky Ro, Marina Halim, and Judy C. Stribling
Author affiliations: George Washington University, Washington, DC, USA (R. Asgary); Weill Cornell Medical College of Cornell University, New York, New York, USA (R. Asgary, N.A. Wahid, J.C. Stribling); New York Presbyterian Hospital of Cornell University, New York (J.A. Snead, N.A. Wahid, M. Halim); Columbia University Vagelos College of Physicians and Surgeons, New York (V. Ro)

Main Article

Table 3

Results of qualitative assessment of studies evaluating risk for CDI in the community*

Study (reference) Study type Year No. persons/studies Setting Actual risk/assumed risk Intervention
Pépin et al. (8)
 Retrospective
 2012
 2,222 C. difficile patients
 Household contacts
 Children attack rate: 4.71 cases/1,000 persons; spouse attack rate: 5.99 cases/1,000 persons
 None
Chitnis et al. (6)
 Retrospective and telephone interview
 2013
 984 community- acquired C. difficile patients
 Household contacts
 Odds of community- acquired CDI if no outpatient healthcare exposure: 6.8 (95% CI 0.7–65.9); odds of community-acquired CDI if low level outpatient healthcare exposure: 6.9 (95% CI 0.9‒56.7)
 None
Durovic et al. (11)
 Narrative review
 2018
 24 studies
 Other healthcare facilities and community
 Not measured
 None
Bloomfield and Riley (12)
 Narrative review
 2016
 NA
 Household contacts
 Estimated rate of community acquired CDI in North America: 20%–32%
 None
Loo et al. (10)
 Prospective
 2016
 51
 Household contacts
 Probable transmission: 1.5%; possible transmission: 7.5%
 None, but type of soap for handwashing was recorded
Miller et al. (9) Case‒control 2020 194,424 enrollees Household contacts IRR 12.47 (95% CI 8.86–16.97) None

*CDI, Clostridioides difficile infection; IRR, incidence rate ratio.

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