Blame the Dog: Tracking C. difficile Infections

A small Montreal study shows children and, in some cases, even the family dog play a part in recurrent hospital-acquired Clostridium difficile (C. difficile) infections continuing to spread in the community.

“Our research suggests that household transmission from patients with C. difficile infection could be responsible for a bacterial reservoir for community-associated cases,” said lead author Vivan Loo, McGill University professor, infectious disease specialist and medical microbiologist at the McGill University Health Centre and investigator at its Research Institute.

US Centers for Disease Control and Prevention (CDC) surveillance of C. difficile infections under its Emerging Infections Program Healthcare Associated Infections-Community Interface (HAIC) cite half a million cases causing 29,000 U.S. deaths in 2011. Symptoms can be as mild as abdominal cramping and diarrhea. Unchecked infections lead to pseudomembranous colitis or toxic megacolon where the colon fails completely. Unable to expel gas or fecal matter at all the colon distends to the point of a fatal perforation or rupture.

“These infections can be serious, so it is important that everyone follows simple hygienic practices, like hand washing with soap and water, even in your own home,” said Loo.

Published in the August 2016 Infection Control & Hospital Epidemiology Household Transmission of Clostridium difficile to Family Members and Domestic Pets followed 51 patients treated for C. difficile infection in hospital or outpatient settings. Researchers made home visits on a monthly basis and took stool samples from the entire household, including any domestic animals. Participants initially testing negative for C. difficile were monitored for eventual infection or asymptomatic colonization.

The results revealed 13.4% of the 67 human household contacts had C. difficile isolated from their stool or rectal samples. One adult household member had diarrhea and the remaining eight were asymptomatically colonized. Sixty-six percent of those colonized were younger than five years old, including five in diapers.

More than a quarter (26.7%) of the 15 domestic pets were asymptomatic carriers of the bacterium, as well. When analyzing the bacteria strains from pets, researchers found that the strains carried by the pets and by their human contacts were indistinguishable or closely related, suggesting interspecies transmission.

The study concluded that pets can be reservoirs for re-infection or transmission of C. difficile whose spores can persist in the environment for months and spread through the air with as little effort as it takes to shake out a blanket when changing a patients sheets.

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