Bacteria that cause a troublesome and sometimes fatal type of diarrhea in hospital patients can be found in and on the bodies of people who have no symptoms at all, U.S. researchers reported.
Their findings could help explain how the bacteria, called Clostridium difficile, manages to thrive despite efforts to eradicate it.
Incontinent patients and those who have been treated for the infection before are among the likely carriers, Dr. Curtis Donskey of the Louis Stokes Cleveland Veterans Affairs Medical Center and colleagues found.
They tested 73 patients in two wards of their hospital, five of whom had diarrhea at the time.
They found that 35 of the 68 patients who did not have symptoms — half the total — were carrying dangerous C. difficile bacteria. Twenty percent had the bacteria or spores on their hands but not on rectal swabs — suggesting that they had picked them up from other patients or hospital staff.
Many had also spread the bacteria to beds, bed rails and other surroundings.
"Our findings suggest that asymptomatic carriers of epidemic and non-epidemic C. difficile strains could contribute significantly to transmission in long-term care facilities," Donskey said in a statement.
"Simple modifications of current infection control practices, including glove use by health care workers and use of 10 percent bleach for room disinfection, could reduce the risk of transmission from asymptomatic carriers."
Spread through touch
Other recent studies have shown the C. difficile bacteria are commonly spread by unhygienic practices in hospitals.
Writing in the journal Clinical Infectious Diseases, Donskey and colleagues said health care workers may need to change standard practice, in which they customarily treat and isolate only patients who have symptoms.
C. difficile is the most common cause of hospital-acquired diarrhea, with 300,000 cases a year in U.S. acute care facilities.
Like other bacteria, people carry it on their hands and spread it when they touch objects, including hospital beds, equipment and doors. It forms spores that are not killed by alcohol hand sanitizers but can be destroyed with bleach.
Carlene Muto of the University of Pittsburgh School of Medicine said the study may help show how various infections spread in hospitals.