Comparison of two selective media for the recovery of Clostridium difficile from environmental surfaces

Hill, K.; Collins, J.; Wilson, Lesley; Perry, John D.; Gould, F.K.

doi:10.1016/j.jhin.2012.10.006

Cited by 16 publications

(15 citation statements)

References 9 publications

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“…However, this method can be used only for spot sampling, as it is limited to the surface area of the contact plate used. Sponge swabs have been used for the sampling of surfaces in the patient environment (14,15). The ability to apply pressure during manual swabbing with a sponge allows the operator to recover C. difficile contamination, both vegetative cells and spores, more effectively, and the sponge swab may be manipulated around the contours of the test surface to contact a range of points greater than the number that would be reached with the contact plate, which would otherwise be missed when the contact plate (which has an area of approximately 25-cm 2 ) is used.…”

Section: Discussionmentioning

confidence: 99%

“…Recovery of C. difficile contamination may be improved by sampling with a sponge swab. However, several studies have subjected sponge swabs to enrichment in nutrient-rich medium before they are plated on selective agar (14,15). Consequently, enrichment limits an assessment to a qualitative result to denote only the presence/absence of C. difficile on surfaces.…”

Section: Discussionmentioning

confidence: 99%

“…The elution of C. difficile cells or spores captured in sponge swabs and passage of the resulting solution through a filter membrane before plating on selective agar conferred three main benefits. First, the primary advantage of our sampling protocol is the ability to generate quantitative (numerical) readings of the C. difficile bioburden, as opposed to the qualitative (presence/absence) results obtained by enrichment methods (14,15,19). Second, this technique is highly sensitive with a theoretical detection limit of 0 CFU.…”

Section: Discussionmentioning

confidence: 99%

“…Second, this technique is highly sensitive with a theoretical detection limit of 0 CFU. Third, the removal of the enrichment stage used in other studies (14,15) reduced the turnaround time (which is typically 5 to 7 days) and enabled the quantitative measurement of C. difficile contamination present on surfaces within 2 days from the time of initial sampling. Further, the use of a 0.45-m-pore-size membrane filter ensured that the pore size was adequate for the capture of most C. difficile bacteria and spores (which are 0.5 to 0.7 m in size).…”

Section: Discussionmentioning

confidence: 99%

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A Novel Quantitative Sampling Technique for Detection and Monitoring of Clostridium difficile Contamination in the Clinical Environment

2015

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The horizontal transmission of Clostridium difficile in the hospital environment is difficult to establish. Current methods to detect C. difficile spores on surfaces are not quantitative, lack sensitivity, and are protracted. We propose a novel rapid method to detect and quantify C. difficile contamination on surfaces. Sponge swabbing was compared to contact plate sampling to assess the in vitro recovery of C. difficile ribotype 027 contamination (ϳ10 0 , 10 1 , or 10 2 CFU of spores) from test surfaces (a bed rail, a stainless steel sheet, or a polypropylene work surface). Sponge swab contents were concentrated by vacuum filtration, and the filter membrane was plated onto selective agar. The efficacy of each technique for the recovery of C. difficile from sites in the clinical environment that are touched at a high frequency was evaluated. Contact plates recovered 19 to 32% of the total contamination on test surfaces, whereas sponge swabs recovered 76 to 94% of the total contamination, and contact plates failed to detect C. difficile contamination below a detection C lostridium difficile infection (CDI) remains one of the most clinically important health care-associated infections and continues to burden health care services and finances (1, 2). The presentation of the disease can vary from mild diarrhea to severe colitis (3) and toxic dilatation that requires colectomy or may result in death. The use of proton pump inhibitors, residence in long-term-care facilities, and use of antibiotics are recognized risk factors (4, 5). However, the increasing incidence of communityacquired CDI suggests that other contributory factors may be responsible for the spread of the disease (6, 7). The horizontal transmission of CDI is implicated in patients with or without diarrhea, who may shed spores of C. difficile to contaminate their surrounding surfaces (8). Spores of C. difficile can persist on hospital surfaces for months (9), posing a risk of spreading to surfaces beyond the near patient environment, such as via the hands of patients, visitors, and health care workers (10).To reduce the risk of transmission, patients considered to be sources of CDI should be isolated upon presentation of symptoms of diarrhea, and an enhanced cleaning protocol should be implemented (11). Decontamination of surfaces in the clinical environment using a sporicide is recommended for C. difficile-positive cases only (11). However, patients may remain asymptomatic, even though they are excreting C. difficile (3), and will not prompt the implementation of infection control measures in the absence of diarrhea. Consequently, patients with asymptomatic cases of C. difficile disease may continue to contaminate the clinical environment unhindered unless a carrier status is diagnosed.Assessment of surfaces in the patient environment to monitor contamination levels and the persistence of C. difficile spores is not routinely performed. Current methods to sample surfaces for C. difficile contamination are not quantitative, have a low sensitivity, and req...

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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A Novel Quantitative Sampling Technique for Detection and Monitoring of Clostridium difficile Contamination in the Clinical Environment

2015

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“…The chromID C. difficile medium has also been evaluated for cultivation of C. difficile from environmental surfaces within a hospital setting and compared to cefoxitin cycloserine egg yolk agar with lysozyme for this purpose (81). By using a combination of both media, C. difficile was recovered from 21% of the sites sampled, but the sensitivity of chromID agar was significantly higher than that of CCEY with lysozyme (87.6% compared to 26.6%) (81).…”

Section: Laboratory Methods For Clostridium Difficile Detection Methodsmentioning

confidence: 99%

Diagnosis of Clostridium difficile Infection: an Ongoing Conundrum for Clinicians and for Clinical Laboratories

2013

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SUMMARY Clostridium difficile is a formidable nosocomial and community-acquired pathogen, causing clinical presentations ranging from asymptomatic colonization to self-limiting diarrhea to toxic megacolon and fulminant colitis. Since the early 2000s, the incidence of C. difficile disease has increased dramatically, and this is thought to be due to the emergence of new strain types. For many years, the mainstay of C. difficile disease diagnosis was enzyme immunoassays for detection of the C. difficile toxin(s), although it is now generally accepted that these assays lack sensitivity. A number of molecular assays are commercially available for the detection of C. difficile . This review covers the history and biology of C. difficile and provides an in-depth discussion of the laboratory methods used for the diagnosis of C. difficile infection (CDI). In addition, strain typing methods for C. difficile and the evolving epidemiology of colonization and infection with this organism are discussed. Finally, considerations for diagnosing C. difficile disease in special patient populations, such as children, oncology patients, transplant patients, and patients with inflammatory bowel disease, are described. As detection of C. difficile in clinical specimens does not always equate with disease, the diagnosis of C. difficile infection continues to be a challenge for both laboratories and clinicians.

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Hygienemaßnahmen bei Clostridioides difficile-Infektion (CDI)

2019

Bundesgesundheitsbl

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Comparison of two selective media for the recovery of Clostridium difficile from environmental surfaces

Cited by 16 publications

References 9 publications

A Novel Quantitative Sampling Technique for Detection and Monitoring of Clostridium difficile Contamination in the Clinical Environment

A Novel Quantitative Sampling Technique for Detection and Monitoring of Clostridium difficile Contamination in the Clinical Environment

Diagnosis of Clostridium difficile Infection: an Ongoing Conundrum for Clinicians and for Clinical Laboratories

Hygienemaßnahmen bei Clostridioides difficile-Infektion (CDI)

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