Prevalence of asymptomatic Clostridium difficile colonization in a nursing home population: a cross-sectional study.

Objective: We conducted a cross-sectional study to determine the prevalence of asymptomatic Clostridium difficile in a nursing home population.

Methods: Inclusion criteria for the study required that the subjects be residents of the facility for more than 1 month. Exclusion criteria included: (1) patients who developed C. difficile infection within 2 months prior to stool collection; (2) metronidazole or vancomycin therapy within 2 months prior to stool collection; (3) past surgical history of colectomy; and (4) possible signs and symptoms of active C. difficile infection.

Results: The prevalence of asymptomatic C. difficile infection in this population was 5%. There was no significantly higher prevalence of asymptomatic C. difficile based on age, race, length of stay, gender, diabetes, renal failure, history of cancer, recent antibiotic use, gastric tube, histamine2 blocker/proton pump inhibitor use, Foley catheter, or dementia.

Conclusions: The prevalence of asymptomatic C. difficile in this population is similar to previously studied populations. Further research should follow a cohort of asymptomatic individuals with C. difficile to determine if colonization may be protective against symptomatic infection.