Asymptomatic patients recently discharged from a hospital may be a source of household transmission of Clostridioides difficile infection (CDI), according to a study published in the May issue of Emerging Infectious Diseases.

Aaron C. Miller, from University of Iowa in Iowa City, and colleagues evaluated whether hospitalized patients without diagnosed CDI increased the risk for CDI among their family members after discharge. Analysis used U.S. insurance claims data (2001 to 2017).

The researchers found that CDI incidence among insurance enrollees exposed to a recently hospitalized family member was 73 percent greater than enrollees not exposed, and incidence increased with length of hospitalization among family members. There was a dose-response relationship observed between total days of within-household hospitalization and CDI incidence rate ratio. The incidence rate ratio increased from 1.30 for one to three days of hospitalization to 2.45 for >30 days of hospitalization, compared to persons whose family members were hospitalized less than one day.

“Asymptomatic C. difficile carriers discharged from hospitals could be a major source of community-associated CDI cases and should be considered by public health authorities during surveillance and intervention-based investigations when a CDI outbreak occurs,” the authors write.

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