Use of Whole Genome Sequencing to Investigate the Risk for Transmission of Clostridioides difficile From Prior Room Occupants: A Single-Center Study

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ID: 328332
2026
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Ranked #559 of 635 articles by views in Clinical infectious diseases : an official publication of the Infectious Diseases Society of America

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Abstract
BACKGROUND: Admission to a room previously occupied by a patient with Clostridioides difficile infection (CDI) has been identified as a risk factor for CDI. However, previous studies have not included molecular typing to definitively link healthcare-associated CDI (HA-CDI) cases to prior room occupants. METHODS: In a hospital and affiliated long-term care facility, we conducted a 1-year cohort study to determine if exposure to a room previously occupied by a CDI patient and/or with environmental contamination after cleaning and disinfection in the past 3 months was associated with an increased risk of HA-CDI. Multivariable logistic regression was used to assess risk factors for HA-CDI. Whole genome sequencing was used to determine the relatedness of HA-CDI isolates and isolates from prior CDI cases or environmental surfaces. RESULTS: Of 5,746 admitted patients, 55 were diagnosed with HA-CDI. Exposure to a room previously occupied by a CDI patient and/or with a positive post-discharge culture was not associated with an increased risk of HA-CDI (adjusted odds ratio 1.15, 95% confidence interval 0.65-1.98; P=0.62). None of the 21 HA-CDI patients with prior room-level exposures were infected with isolates genomically related to isolates from prior room occupants with CDI or from room surfaces. Five HA-CDI cases were linked to prior CDI patients or environmental isolates on the same ward or without ward-level exposure. CONCLUSION: Despite frequent exposure to rooms previously occupied by CDI patients or contaminated with C. difficile, no HA-CDI cases were linked to prior room exposures in a facility using sporicidal disinfectants in CDI rooms.
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Authors Sarah N. Redmond, Maria M. Torres-Teran, Jennifer L. Cadnum, Claire E. Kaple, Samir Memic, Munok Hwang, Hosoon Choi, Piyali Chatterjee, Chetan Jinadatha, Curtis J. Donskey
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Journal Clinical infectious diseases : an official publication of the Infectious Diseases Society of America
Year 2026
DOI
10.1093/cid/ciag547
URL
https://doi.org/10.1093/cid/ciag547
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