Clostridioides difficiletransmission: a compartmental model accounting for environmental spore persistence

Abstract

AbstractObjectiveTo set up a compartmental model, including environmental spore levels, forC. difficiletransmission dynamics in a hospital and determine the effect of preventive interventions on infection and colonization rates.DesignIntervention study within a compartmental mathematical modeling framework.SettingA simulated Swedish 500-bed secondary care hospital.Interventions modeledAntibiotic stewardship, improved isolation of infected patients, improved general cleaning and disinfection.ResultsAntibiotic stewardship had the largest effect on infections, with a 30.6% decrease in infection prevalence. Improved general cleaning and disinfection had the largest effect on colonization (–22.5%) and environmental spore levels (–39.7%). Improved isolation of infected patients had modest effects in comparison.ConclusionsModeling that includes the dynamics of environmental spores can aid our understanding ofC. difficiletransmission within hospitals. Antibiotic stewardship and improved general cleaning and disinfection showed the largest potential for prevention in our modeled setting.