Acquisition of Clostridium difficile from the hospital environment

Am J Epidemiol. 1988 Jun;127(6):1289-94. doi: 10.1093/oxfordjournals.aje.a114921.


An outbreak of antibiotic-associated colitis that occurred on a ward of a Michigan hospital during February-April, 1984, was studied by bacteriophage-bacteriocin typing. Stools from the seven involved patients yielded Clostridium difficile isolates of types B1537 or Cld7;B1537. C. difficile was recovered from 31.4% of environmental cultures obtained on the ward, and the majority of isolates were types B1537 or Cld7;B1537. When the ward was disinfected with unbuffered hypochlorite (500 parts per million (ppm) available chlorine), surface contamination decreased to 21% of initial levels and the outbreak subsequently ended. Phosphate buffered hypochlorite (1,600 ppm available chlorine, pH 7.6) was even more effective; its use resulted in a 98% reduction in surface contamination. These findings suggest that environmental contamination with C. difficile is important in the epidemiology of antibiotic-associated colitis, and that hypochlorite is effective in eliminating C. difficile from the hospital environment.

Publication types

  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Clostridium / isolation & purification
  • Cross Infection / epidemiology
  • Cross Infection / microbiology*
  • Disease Outbreaks*
  • Disinfection
  • Enterocolitis, Pseudomembranous / epidemiology
  • Enterocolitis, Pseudomembranous / transmission*
  • Environmental Microbiology*
  • Epidemiologic Methods
  • Feces / microbiology
  • Humans
  • Hypochlorous Acid
  • Male
  • Michigan
  • Middle Aged


  • Hypochlorous Acid