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BioMed Research International
Volume 2017, Article ID 5450829, 6 pages
Research Article

Identification of Clostridium difficile Asymptomatic Carriers in a Tertiary Care Hospital

1Clinical Laboratory, Hospital Israelita Albert Einstein, São Paulo, SP, Brazil
2Division of Medical Practice, Hospital Israelita Albert Einstein, São Paulo, SP, Brazil
3Office of Clinical Quality, Safety and Performance Improvement, University of Iowa Hospitals and Clinics, Iowa City, IA, USA
4Instituto Israelita de Ensino e Pesquisa Albert Einstein, Hospital Israelita Albert Einstein, São Paulo, SP, Brazil

Correspondence should be addressed to Alexandre R. Marra; rb.nietsnie@arram.erdnaxela

Received 13 April 2017; Revised 11 August 2017; Accepted 27 August 2017; Published 2 October 2017

Academic Editor: Naohiko Masaki

Copyright © 2017 André Luiz de Oliveira Silva et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


Background. The diagnosis of Clostridium difficile infection (CDI) increases concern that asymptomatic carriers of toxigenic C. difficile may be diagnosed with CDI. Methods. A matched case control study was conducted in inpatients in a tertiary care center. The first 50 patients with diarrhea and a positive polymerase chain reaction (PCR) test beginning February 1, 2015, were identified as cases. Control patients were hospitalized patients receiving antibiotics, but with no diarrhea, housed in a room as close as possible to each case during the same admission time. A convenience sample of healthcare workers who cared for C. difficile infected patients was also tested. Results. We found two positive PCR results for C. difficile in controls (4.1%). None of these healthcare workers were positive for C. difficile by PCR. There was no difference between groups with respect to overall antibiotic use before the requested PCR for Clostridium difficile (). The majority of cases had a high proportion of gastrointestinal disorders (71.4%) compared with control (8.2%), . Patients with neoplasia had a higher chance of being identified as cases (). Conclusions. PCR should not be the only diagnostic tool but should be complementary to other methods and to the medical history.