title: Is Clostridium difficile endemic in chronic-care facilities?
abstract: An apparent outbreak of Clostridium difficile diarrhoea on the chronic hospital ward of a long-term care facility prompted an investigation lasting seven months. Approximately a third of patients had stools that were positive for C difficile by either toxin or culture. Attempts to eradicate the infection by simultaneously treating all toxin-positive patients with metronidazole, limiting antibiotic use, and implementing enteric isolation were unsuccessful. New cases were both nosocomially acquired and imported into the facility. Of the C difficile toxin-positive patients, 34% had diarrhoea and 19/49 (38%) died during the study period. C difficile is not routinely sought by most clinical microbiology laboratories and may therefore be endemic in many long-term care facilities for the elderly.
authors.forename: B S
authors.initials: BS
authors.lastname: Bender
authors.forename: R
authors.initials: R
authors.lastname: Bennett
authors.forename: B E
authors.initials: BE
authors.lastname: Laughon
authors.forename: W B
authors.initials: WB
authors.lastname: Greenough
authors.forename: C
authors.initials: C
authors.lastname: Gaydos
authors.forename: S D
authors.initials: SD
authors.lastname: Sears
authors.forename: M S
authors.initials: MS
authors.lastname: Forman
authors.forename: J G
authors.initials: JG
authors.lastname: Bartlett
mesh_terms: D000328:Adult; D000368:Aged; D001427:Bacterial Toxins / Q000032:analysis; D003015:Clostridium Infections / Q000453:epidemiology* / Q000517:prevention & control; D003428:Cross Infection / Q000453:epidemiology*; D003967:Diarrhea / Q000453:epidemiology / Q000517:prevention & control; D004196:Disease Outbreaks / Q000453:epidemiology*; D005243:Feces / Q000032:analysis / Q000382:microbiology; D005260:Female; D006763:Hospitals, Chronic Disease; D006782:Hospitals, Special; D006801:Humans; D008297:Male; D008396:Maryland; D008875:Middle Aged
chemical_list: D001427:Bacterial Toxins