Methods: As part of a Texas hospital-wide surveillance effort, we collected shoe-bottom swabs samples from hospital employees, patients, and visitors inside three large hospital from three cities. Samples were analyzed for C. difficile using anaerobic enrichment culture and molecular methods. Suspected colonies from cycloserine cefoxitin fructose agar (CCFA) plates were identified by PCR (tcdA, tcdB, cdtA, cdtB, tpi) and genotyped using fluorescent PCR ribotyping.
Results: A total 229 of 1079 (21.2%) surface swab and 81 of 121(66.9%) shoe swab samples were culture positive for toxigenic C. difficile (tcdA and tcdB). A total of 29 distinct ribotypes were identified from 166 C. difficile isolates tested. Predominant ribotypes were F106, F019, F014-020, F002, and F255. Interestingly, ribotype F027 was not a predominant strain among the swab samples. Each hospital had widely diverse strains. Shoes were the most contaminated item in all the hospitals.
Conclusion: We identified a high prevalence of toxigenic C. difficile with diverse ribotypes from hospital environmental shoe-bottom swabs and high touch surface swabs in hospitals in three cities of Texas. Our findings suggest that patients might be at higher risk for C. difficile colonization or infection in these hospitals.
M. J. Alam,
J. McPharson, None
J. Miranda, None
F. Hossain, None
K. Poblete, None
K. W. Garey, Merck & Co.: Grant Investigator , Grant recipient .