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'Facts' of C. Diff Transmission Challenged

A sophisticated genetic analysis of Clostridium difficile cases is challenging the conventional wisdom that symptomatic patients are responsible for most transmission in hospitals.

Whole-genome sequencing of C. difficile isolates from more than 1,200 patients found that only 35% were related to a previous case in a large, four-hospital study, according to David Eyre, BMBCh, of John Radcliffe Hospital in Oxford, England, and colleagues.

And 45% were genetically distinct from all other cases, suggesting that diverse sources -- not just patients with C. difficile disease -- are responsible for a large proportion of transmissions, Eyre and colleagues reported in the Sept. 26 issue of the New England Journal of Medicine.

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