An infection prevention dilemma: should we place patients with C. difficile colonization on contact precautions?

The project will determine the frequency, location, and amount of environmental C. difficile contamination among 300 patients with C. difficile colonization (150 with diarrhea and 150 without diarrhea) compared to 150 patients with C. difficile infection (Specific Aim 1). It will then determine the frequency, location, and amount of C. difficile contamination on 900 healthcare providers' hands, clothes, and 450 pieces of mobile, shared equipment following routine inpatient care of patients with C. difficile colonization (Specific Aim 2). Finally, it will use approximately 1,500 C. difficile isolates from a biorepository and study activities to evaluate potential sources for C. difficile in-hospital transmission using molecular epidemiology and whole genome sequencing (Specific Aim 3).