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Household Transmission of Clostridium difficile to Family Members and Domestic Pets

  • Vivian G. Loo (a1), Paul Brassard (a1) and Mark A. Miller (a2)

Abstract

OBJECTIVE

To determine the risk of Clostridium difficile transmission from index cases with C. difficile infection (CDI) to their household contacts and domestic pets.

DESIGN

A prospective study from April 2011 to June 2013.

SETTING

Patients with CDI from Canadian tertiary care centers.

PARTICIPANTS

Patients with CDI, their household human contacts, and pets.

METHODS

Epidemiologic information and stool or rectal swabs were collected from participants at enrollment and monthly for up to 4 months. Pulsed-field gel electrophoresis (PFGE) was performed on C. difficile isolates. Probable transmission was defined as the conversion of a C. difficile culture–negative contact to C. difficile culture–positive contact with a PFGE pattern indistinguishable or closely related to the index case. Possible transmission was defined as a contact with a positive C. difficile culture at baseline with a strain indistinguishable or closely related to the index case.

RESULTS

A total of 51 patients with CDI participated in this study; 67 human contacts and 15 pet contacts were included. Overall, 9 human contacts (13.4%) were C. difficile culture positive; 1 contact (1.5%) developed CDI; and 8 contacts were asymptomatic. Of 67 human contacts, probable transmission occurred in 1 human contact (1.5%) and possible transmission occurred in 5 human contacts (7.5%). Of 15 pet contacts, probable transmission occurred in 3 (20%) and possible transmission occurred in 1 (6.7%).

CONCLUSIONS

There was a high proportion of C. difficile culture positivity at 13.4% among human contacts and asymptomatic carriage of domestic pets reached 26.7%. These results suggest that household transmission of C. difficile may be a source of community-associated cases.

Infect Control Hosp Epidemiol 2016;1–7

Copyright

Corresponding author

Address correspondence to Dr Vivian G. Loo, Division of Infectious Diseases and Department of Microbiology, McGill University Health Centre, 1001 Décarie Blvd. Room E05.1824, Montréal, Québec, Canada, H4A 3J1 (vivian.loo@mcgill.ca).

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