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Role of the Household Environment in Transmission of Clostridioides difficile Infection: A Scoping Review

Abstract

The environment plays a role in healthcare-associated Clostridioides (formerly Clostridium) difficile infection (CDI); however, the role of the environment in community-associated CDI is unknown. The objective of this scoping review was to describe the literature related to the transmission of C. difficile in the household environment. We conducted searches of four electronic health and science databases to identify relevant studies. In total, 39 articles published between 1981 and 2020 met the a priori inclusion criteria. Slightly over one half (51.3%, 20 out of 39) of the articles were nonsystematic review articles and thus we excluded them from the synthesis of results. Overall, we included 19 articles in the synthesis of results. None of the studies were experimental studies. Studies assessed or estimated the prevalence of C. difficile on household surfaces, colonization of household members (human and animal), or the risk of transmission in the household. This scoping review provides an overview of the global literature related to the role of the household environment in transmission of C. difficile. We found a lack of research in this area. Further studies are needed and ideally would be designed to follow household members over time and to test the effectiveness of interventions such as targeted hygiene protocols. 

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Volume: 85
Number: 6
Pages: 8-14
Published: January/February 2023

Authors

  • Catherine D. Egan, MBA, CPHI(C), CIC, Department of Pathobiology, University of Guelph, Conestoga College 
  • Jan M. Sargeant, MSc, DVM, PhD, FCAHS, Department of Population Medicine and Centre for Public Health and Zoonoses, University of Guelph 
  • J. Scott Weese, DVSc, DVM, Dipl. ACVIM, Department of Pathobiology and Centre for Public Health and Zoonoses, University of Guelph 
  • Andria Jones-Bitton, DVM, PhD, Department of Population Medicine and Centre for Public Health and Zoonoses, University of Guelph 
  • Shawn E. Zentner, MPH, CPHI(C), Wellington–Dufferin–Guelph Public Health 

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