ArticleEpidemiology and infection2019
Modelling diverse sources of Clostridium difficile in the community: importance of animals, infants and asymptomatic carriers.
Article in Epidemiology and infection, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 14 papers.
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Who cites it
14 citing papers in PubMed.
- BeyondEmerging microbes & infections · 2026Article
- Clostridioides difficile colonization amplification despite limited in-hospital transmission: A modeling study.PLoS medicine · 2026Article
- The contribution of community transmission to the burden of hospital-associated pathogens: A systematic scoping review of epidemiological models.One health (Amsterdam, Netherlands) · 2025Review
- Defining the phylogenetics and resistome of the majorMicrobial genomics · 2024Article
- Mucosal Vaccination Strategies againstVaccines · 2023Review
- Neutralising Effects of Different Antibodies onInternational journal of molecular sciences · 2023Article
- The World of Organoids: Gastrointestinal Disease Modelling in the Age of 3R and One Health with Specific Relevance to Dogs and Cats.Animals : an open access journal from MDPI · 2022Review
- A review of epidemiological models of Clostridioides difficile transmission and control (2009-2021).Anaerobe · 2022Review
- Article
- Clostridioides difficile phage biology and application.FEMS microbiology reviews · 2021Review
- What's a Biofilm?-How the Choice of the Biofilm Model Impacts the Protein Inventory ofFrontiers in microbiology · 2021Article
- Some simple rules for estimating reproduction numbers in the presence of reservoir exposure or imported cases.Theoretical population biology · 2020Article
- ReducingInfection control and hospital epidemiology · 2020Article
- High Prevalence of Multidrug-ResistantFrontiers in cellular and infection microbiology · 2020Article
Corrections and comments
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Authors and funding
4 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Clostridium difficile infections (CDIs) affect patients in hospitals and in the community, but the relative importance of transmission in each setting is unknown. We developed a mathematical model of C. difficile transmission in a hospital and surrounding community that included infants, adults and transmission from animal reservoirs. We assessed the role of these transmission routes in maintaining disease and evaluated the recommended classification system for hospital- and community-acquired CDIs. The reproduction number in the hospital was 1 for nearly all scenarios without transmission from animal reservoirs (range: 1.0-1.34). However, the reproduction number for the human population was 3.5-26.0%) of human exposures originated from animal reservoirs. Symptomatic adults accounted for <10% transmission in the community. Under conservative assumptions, infants accounted for 17% of community transmission. An estimated 33-40% of community-acquired cases were reported but 28-39% of these reported cases were misclassified as hospital-acquired by recommended definitions. Transmission could be plausibly sustained by asymptomatically colonised adults and infants in the community or exposure to animal reservoirs, but not hospital transmission alone. Under-reporting of community-onset cases and systematic misclassification underplays the role of community transmission.
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