Report of an outbreak of Clostridium difficile infection caused by ribotype 053 in a neurosurgery unit

Aaron Nagar*, Peter Yew, Derek Fairley, Mary Hanrahan, Stephen Cooke, Irene Thompson, Wesam Elbaz

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

5 Citations (Scopus)

Abstract

Background: We describe an outbreak of Clostridium difficile infection (CDI) with ribotype 053, a possible hypervirulent strain that causes outbreaks, in a neurosurgical unit. Outbreak investigation:The outbreak was investigated by creating a timeline of all toxin positive patients with root cause analysis, supplemented with ribotyping results, hand hygiene and environmental audits. There were five cases of CDI, three caused by ribotype 053 indicating transmission. Infection prevention measures: These included a short period of ward closure to allow enhanced cleaning, including use of vaporised hydrogen peroxide, isolation of infected patients, reinforcement of hand hygiene, education of all staff on C. difficile, reduction of shared bay occupancy from six to four, and addressing staffing levels. Discussion: The patients with ribotype 053 all had long inpatient stays and had required several courses of broad-spectrum antibiotics for aspiration pneumonia. They also required enteral feeding, which can cause diarrhoea, and during long inpatient stays they had multiple toxin negative faecal samples making clinical diagnosis of CDI difficult. Hence they were not isolated promptly, leading to transmission. This is the first reported outbreak of C. difficile ribotype 053 in the UK and highlights the unique aspects of an outbreak in neurosurgical patients.
Original languageEnglish
Pages (from-to)126-130
JournalJournal of Infection Prevention
Volume16
Issue number3
Early online date16 Dec 2014
DOIs
Publication statusPublished - 06 May 2015
Externally publishedYes

Keywords

  • Clostridium difficile
  • healthcare-associated infection
  • infection control
  • outbreak

ASJC Scopus subject areas

  • Health Policy
  • Public Health, Environmental and Occupational Health
  • Advanced and Specialised Nursing
  • Infectious Diseases

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