Clostridium difficile can travel by air, contaminating surfaces and potentially infecting patients and healthcare workers who come into contact with those surfaces, British researchers have found.

While some studies have suggested that C. diff might be able to spread through the air, few have been able to substantiate the risk of airborne transmission in hospitals. Researchers led by Mark H. Wilcox, MD, professor of medical microbiology at the University of Leeds, sought to assess the risk of airborne contamination by sampling the air surrounding 63 patients with confirmed C. diff infection (CDI) for a total of 180 hours. Their findings were published in the journal Clinical Infectious Disease.

Among the first 50 patients, who were examined for 1 hour each, 12% had air samples that tested positive for C. diff; patients with active symptoms were more likely to test positive. In a more intensive study of 10 patients with active CDI over a 10-hour period, C. diff was detected in the air near 7 of the 10 patients and on surfaces near 9 of the 10.

The authors conclude that C. diff "is commonly but sporadically present in the air close to symptomatic patients with CDI." They found that airborne bacteria were more present during periods of activity in patients' quarters, suggesting that "people movement, including the opening and closing of doors, contributes to the circulation and dispersal of airborne C. difficile." Activities like making patient beds and drawing curtains could also contribute to the spread of C. diff.

The findings highlight the importance of frequent hand washing in healthcare settings and frequent cleaning of surfaces around symptomatic patients to prevent the reaccumulation of bacteria traveling through the air, write the study authors. They also urge healthcare facilities to isolate patients to single rooms "as soon as possible after the onset of diarrhea," even before they are confirmed to have CDI. "Allowing even a few hours before patient isolation may not be adequate to prevent environmental dissemination of C. difficile via the air."

Irene Tsikitas

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