Common bacteria in hospital may not result from transmission
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Hospital-acquired infections, also called healthcare-associated infections (HAI), are common. They are identified as infections not present when the patient is first admitted to the hospital. Some common conditions include catheter-associated UTIs, bloodstream infections, surgical site infections, pneumonia, and Clostridioides difficile infections.
Clostridioides difficile, commonly called C diff, is a highly contagious bacteria that causes an infection of the colon. Most infections occur in hospital settings, and illnesses due to C Diff happen usually after consuming antibiotic medicines. Only 5% of the population outside of a healthcare setting has C. diff in their gut, where it typically causes no issues.
But, contrary to popular opinion that C Diff infections mainly occur due to hospital environments, a new study suggests that the conditions might be happening less due to hospital transmissions but more due to characteristics associated with the patients themselves.
What triggers C Diff?
“Something happened to these patients that we still don’t understand to trigger the transition from C. diff hanging out in the gut to the organism causing diarrhea and the other complications resulting from infection,” said Evan Snitkin, Ph.D. candidate at the University of Michigan Medical School.
The researchers studied the poop of 1,100 patients at the intensive care unit at Rush University Medical Center over nine months. After going over nearly 4,000 specimens of fecal matter from these patients, the team found that almost 100 patients were infected with C diff. Using whole genome sequencing, the team also compared different C diff strains they had picked up during the analyzing stage.
The team found little evidence to suggest that the strains of C diff from one patient to the next were the same. This implied that there was minimal in-hospital acquisition. Based on the genomics, there was minimal transmission from one patient to another. The team recorded only six genomically supported messages over the study period.
Integrating their work with AI
Dr. Mary Hayden at the Rush University Medical Center said that the proper hygiene protocol and routine environmental disinfection were carried out at their center, which is probably the reason for the low transmission rate. But, she also noted that the results of this study don’t mean that hospital infection prevention measures are unnecessary.
“We need to figure out ways to prevent patients from developing an infection when we give them tube feedings, antibiotics, proton pump inhibitors—all things which predispose people to get an actual infection with C. diff that causes damage to the intestines or worse,” said Vincent Young, MD, Ph.D., University of Michigan Medical School.
The team, led by researchers at the University of Michigan Medical School and Rush University Medical Center, wants to incorporate artificial intelligence into their work by building machine learning models to predict patients at risk of C. diff infection. This would help identify people likely to be colonized and be saved from the infection by proper intervention.
This study was published in the journal Nature Medicine.
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