ArticleNature medicine2023
Longitudinal genomic surveillance of carriage and transmission of Clostridioides difficile in an intensive care unit.
Article in Nature medicine, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 41 papers, 2 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
41 citing papers in PubMed, 2 syntheses or guidelines pooled it, 52 citations in OpenAlex.
- Clinical significance of toxin EIA positivity in patients with suspectedJournal of clinical microbiology · 2025Pooled it
- How long do bacteria, fungi, protozoa, and viruses retain their replication capacity on inanimate surfaces? A systematic review examining environmental resilience versus healthcare-associated infection risk by "fomite-borne risk assessment".Clinical microbiology reviews · 2024Pooled it
- Gut Colonization With Vancomycin-Resistant Enterococcus Shapes the Gut Microbiome in the Intensive Care Unit.The Journal of infectious diseases · 2025Trial
- Microbiome-based therapeutics forGut microbes · 2026Review
- The prevalence and molecular epidemiology ofEmerging microbes & infections · 2026Observational
- From colonization to infection: Genomic evolution of Clostridioides difficile pathogenesis.Cell reports · 2026Review
- Early-life colonization withScience (New York, N.Y.) · 2026Article
- Multi-strain Clostridioides difficile infection: Increased detection and clinical implications.The Journal of infection · 2026Article
- Optimized Surveillance Testing for ToxigenicmedRxiv : the preprint server for health sciences · 2026Article
- Evaluation of endoscopic processing on the potential forInfection prevention in practice · 2026Article
- Association betweenmedRxiv : the preprint server for health sciences · 2026Article
- Article
- Article
- Clostridioides difficile colonization amplification despite limited in-hospital transmission: A modeling study.PLoS medicine · 2026Article
- Genome sequencing for prevention of health-care-associated bacterial infections.Nature reviews. Microbiology · 2026Review
- Clostridioides difficile pathogenesis and control.Nature reviews. Microbiology · 2026Review
- Comparative genomic analysis ofMicrobial genomics · 2026Article
- Clinical and molecular epidemiology ofFrontiers in microbiology · 2026Article
- Development and Evaluation of a Hallucination Awareness Scale for Healthcare Professionals and its impact on diagnostic confidence.Frontiers in digital health · 2026Article
- Study Protocol for Genomic Epidemiology Investigation of Intensive Care Unit Patient Colonization by Antimicrobial-Resistant ESKAPE Pathogens.Methods and protocols · 2025Article
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Authors and funding
17 authors at 2 institutions in 1 country.
Funding
Abstract
Despite enhanced infection prevention efforts, Clostridioides difficile remains the leading cause of healthcare-associated infections in the United States. Current prevention strategies are limited by their failure to account for patients who carry C. difficile asymptomatically, who may act as hidden reservoirs transmitting infections to other patients. To improve the understanding of asymptomatic carriers' contribution to C. difficile spread, we conducted admission and daily longitudinal culture-based screening for C. difficile in a US-based intensive care unit over nine months and performed whole-genome sequencing on all recovered isolates. Despite a high burden of carriage, with 9.3% of admissions having toxigenic C. difficile detected in at least one sample, only 1% of patients culturing negative on admission to the unit acquired C. difficile via cross-transmission. While patients who carried toxigenic C. difficile on admission posed minimal risk to others, they themselves had a 24-times greater risk for developing a healthcare-onset C. difficile infection than noncarriers. Together, these findings suggest that current infection prevention practices can be effective in preventing nosocomial cross-transmission of C. difficile, and that decreasing C. difficile infections in hospitals further will require interventions targeting the transition from asymptomatic carriage to infection.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.