ABSTRACT
Rectal swabs obtained from 10 of 49 chronic-care geriatric patients were positive for Clostridium difficile, for a prevalence rate of 20.4%. Simultaneous sampling of 29 patients in an acute geriatric ward revealed four colonized patients, for a prevalence rate of 13.7%. A prospective study of C. difficile colonization in 100 consecutive patients admitted to an acute geriatric ward was carried out. All patients were sampled upon admission and biweekly during hospitalization. Two patients (2%) were positive on admission, and 12 of the 98 initially negative patients became colonized, representing a nosocomial acquisition rate of 12.2%. A major determinant for C. difficile colonization in asymptomatic patients appears to be length of hospitalization. Previous antibiotic administration was not found to be a significant factor.
Subject(s)
Clostridioides difficile/isolation & purification , Cross Infection/transmission , Enterocolitis, Pseudomembranous/transmission , Aged , Aged, 80 and over , Cross Infection/epidemiology , Enterocolitis, Pseudomembranous/epidemiology , Equipment Contamination , Female , Humans , Length of Stay , Male , Middle Aged , Prevalence , Prospective Studies , Rectum/microbiology , Time FactorsABSTRACT
Diagnosis of the bacterial component of pressure sores is notoriously difficult. We comparatively studied three methods of specimen collection from 72 pressure sores. Specimens taken by swab or by needle aspiration were compared with deep biopsy specimens as to diagnostic reliability. We found that swab specimens reflected surface colonization and that needle aspiration seemed to underestimate bacterial isolates as compared with deep tissue biopsy specimens. We recommend that antibiotics not be routinely used for treatment of colonization in pressure sores; in patients with sepsis, deep biopsy specimens can accurately diagnose infection.
