Antibiotics Encourage Spread of C.diff To Subsequent Patients Who Occupy the Same Bed and Haven’t Received Antibiotics Interview with:

Dr. Daniel E. Freedberg MD M

Dr. Daniel E. Freedberg

Dr. Daniel E. Freedberg MD MS
Division of Digestive and Liver Diseases
Columbia University Medical Center
New York, New York What is the background for this study?

Response: We conducted this study because previous studies indicate that the gastrointestinal microbiome is easily shared between people who co-occupy a given space (such as a hospital room).  We wondered if antibiotics might exert an effect on the local microbial environment. What are the main findings?

Response: If the patient who was admitted to the hospital before you had received antibiotics, it increased your risk for C. diff. What should readers take away from your report?

Response: This study provides evidence that there is a “herd” effect with antibiotics—in other words, that antibiotics have the potential to affect the health of people who don’t themselves receive antibiotics.

More specifically, in this study, antibiotics seemed to encourage the spread of C. diff from patients who were asymptomatically colonized with C. diff to patients who were C. diff-free, even if the C. diff-free patients did not themselves receive antibiotics. What recommendations do you have for future research as a result of this study?

Response: Future studies may seek to evaluate the mechanisms by which asymptomatic carriers of C. diff transmit spores to other patients.  Future studies may wish to collect samples to determine exactly how one patient’s gut microbiome may affect the gut microbiome of a subsequent patient who enters a shared hospital environment. Is there anything else you would like to add?

Response: This effect between the prior patient’s antibiotics and your risk for C. diff was modest, but it persisted even after we accounted for other factors including whether or not you received antibiotics. Thank you for your contribution to the community.


Receipt of Antibiotics in Hospitalized Patients and Risk for Clostridium difficile Infection in Subsequent Patients Who Occupy the Same Bed
Daniel E. Freedberg, MD, MS et al
JAMA Intern Med. Published online October 10, 2016. doi:10.1001/jamainternmed.2016.6193

Note: Content is Not intended as medical advice. Please consult your health care provider regarding your specific medical condition and questions.

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Last Updated on October 12, 2016 by Marie Benz MD FAAD