Study: Non-Health Care Settings Spread C. Difficile Bacteria


Investigators from the University of Houston find that 45% of the positive samples were from the soles of shoes.

Clostridium difficile, bacteria that cause inflammation of the colon, were found to be widely prevalent within non-health care settings, results of a study by the University of Houston showed.

“We can no longer think of C diff as only existing in health care settings, and the population at risk is no longer just the very sick patient in the hospital,” Kevin Garey, PharmD, MS, professor of pharmacy practice at the UH College of Pharmacy, said in a statement. “Identifying that person at risk anywhere in the world should become a priority, regardless of whether the person is in a hospital or the community.”

The prevalence of C diff has been primarily investigated within hospital settings.

Investigators tested worldwide environmental samples from health care and non-health care and found that 26% of these samples tested positive for a C diff strain. Of the positive samples, 45% were from the soles of shoes.

Investigators collected samples from health care settings, public areas, and shoe soles in the United States and 11 other countries between 2014 and 2017. They compared the rates of positive C diff among the settings to investigate the environmental transmission of the bacteria.

“The bottoms of your shoes aren’t clean,” Jinhee Jo, a postdoctoral infectious disease fellow at the University of Houston, said in the statement.

“They may introduce harmful bacteria into your bathroom or kitchen, which could make you sick,” she said.” The next time you’re coming in from outside, take off your shoes before you enter a highly trafficked room, and help reduce the risk of catching C. difficile.”

The study results were presented at the Infectious Disease Society of America IDWeek.


C. difficile is everywhere. EurekAlert. News release. October 6, 2021. Accessed on October 7, 2021.

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