title: Acquisition of Clostridium difficile from the hospital environment.
abstract: An outbreak of antibiotic-associated colitis that occurred on a ward of a Michigan hospital during February-April, 1984, was studied by bacteriophage-bacteriocin typing. Stools from the seven involved patients yielded Clostridium difficile isolates of types B1537 or Cld7;B1537. C. difficile was recovered from 31.4% of environmental cultures obtained on the ward, and the majority of isolates were types B1537 or Cld7;B1537. When the ward was disinfected with unbuffered hypochlorite (500 parts per million (ppm) available chlorine), surface contamination decreased to 21% of initial levels and the outbreak subsequently ended. Phosphate buffered hypochlorite (1,600 ppm available chlorine, pH 7.6) was even more effective; its use resulted in a 98% reduction in surface contamination. These findings suggest that environmental contamination with C. difficile is important in the epidemiology of antibiotic-associated colitis, and that hypochlorite is effective in eliminating C. difficile from the hospital environment.
authors.affiliation: Department of Internal Medicine, University of Michigan, Ann Arbor.
authors.forename: G W
authors.initials: GW
authors.lastname: Kaatz
authors.forename: S D
authors.initials: SD
authors.lastname: Gitlin
authors.forename: D R
authors.initials: DR
authors.lastname: Schaberg
authors.forename: K H
authors.initials: KH
authors.lastname: Wilson
authors.forename: C A
authors.initials: CA
authors.lastname: Kauffman
authors.forename: S M
authors.initials: SM
authors.lastname: Seo
authors.forename: R
authors.initials: R
authors.lastname: Fekety
mesh_terms: D003013:Clostridium / Q000302:isolation & purification; D003428:Cross Infection / Q000453:epidemiology / Q000382:microbiology*; D004196:Disease Outbreaks; D004203:Disinfection; D004761:Enterocolitis, Pseudomembranous / Q000453:epidemiology / Q000635:transmission*; D004783:Environmental Microbiology; D004812:Epidemiologic Methods; D005243:Feces / Q000382:microbiology; D006801:Humans; D006997:Hypochlorous Acid; D008297:Male; D008824:Michigan; D008875:Middle Aged
chemical_list: D006997:Hypochlorous Acid