title: Clostridium difficile in a children's hospital: assessment of environmental contamination.
abstract: Clostridium difficile infection (CDI) is the most frequent infectious cause of health care-associated diarrhea. Three cases of CDI, in children age 2, 3, and 14 years, occurred in the hematology/oncology ward of our children's hospital over 48 hours. We aimed to assess environmental contamination with C difficile in the shared areas of this unit, and to determine whether person-to-person transmission occurred. C difficile was recovered from 5 of 18 samples (28%). We compared C difficile isolated from each patient and the environment using pulsed-field gel electrophoresis, and found that none of the patient strains matched any of the others, and that none matched any strains recovered from the environment, suggesting that person-to-person transmission had not occurred. We found that C difficile was prevalent in the environment throughout shared areas of the children's hospital unit. Molecular typing to identify mechanisms of transmission is useful for devising appropriate interventions.
authors.affiliation: Department of Medicine, University of Wisconsin Medical School, Madison, WI.
authors.forename: Simone
authors.initials: S
authors.lastname: Warrack
authors.affiliation: Department of Medicine, University of Wisconsin Medical School, Madison, WI.
authors.forename: Megan
authors.initials: M
authors.lastname: Duster
authors.affiliation: University of Wisconsin Hospitals and Clinics, Infection Control, University of Wisconsin, Madison, WI.
authors.forename: Sarah
authors.initials: S
authors.lastname: Van Hoof
authors.affiliation: University of Wisconsin Hospitals and Clinics, Infection Control, University of Wisconsin, Madison, WI.
authors.forename: Michelle
authors.initials: M
authors.lastname: Schmitz
authors.affiliation: Department of Medicine, University of Wisconsin Medical School, Madison, WI; University of Wisconsin Hospitals and Clinics, Infection Control, University of Wisconsin, Madison, WI; William S. Middleton Memorial Veterans Affairs Hospital, Madison, WI. Electronic address: Ns2@medicine.wisc.edu.
authors.forename: Nasia
authors.initials: N
authors.lastname: Safdar
mesh_terms: D000293:Adolescent; D002675:Child, Preschool; D016360:Clostridioides difficile / Q000145:classification / Q000235:genetics / Q000302:isolation & purification*; D003015:Clostridium Infections / Q000453:epidemiology* / Q000382:microbiology / Q000635:transmission; D003428:Cross Infection / Q000453:epidemiology* / Q000382:microbiology / Q000635:transmission; D016521:Electrophoresis, Gel, Pulsed-Field; D004783:Environmental Microbiology; D014644:Genetic Variation; D005838:Genotype; D006776:Hospitals, Pediatric; D006801:Humans; D008297:Male; D017720:Molecular Epidemiology; D058889:Molecular Typing
keywords: Clostridium difficile; Environmental contamination; Pediatric; Pulsed-field gel electrophoresis