Open Access Highly Accessed Research article

Prevalence of Clostridium difficile colonization among healthcare workers

N Deborah Friedman1*, James Pollard1, Douglas Stupart2, Daniel R Knight34, Masoomeh Khajehnoori5, Elise K Davey1, Louise Parry1 and Thomas V Riley34

Author Affiliations

1 Department of Medicine and Infectious Diseases, Barwon Health, Geelong, Victoria, Australia

2 Department of Surgery, Barwon Health, Geelong, Victoria, Australia

3 School of Pathology & Laboratory Medicine, The University of Western Australia, Crawley, WA 6009, Australia

4 PathWest Laboratory Medicine, Queen Elizabeth II Medical Centre, Nedlands, WA 6009, Australia

5 Deakin University Medical School, Geelong, Victoria, Australia

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BMC Infectious Diseases 2013, 13:459  doi:10.1186/1471-2334-13-459

Published: 4 October 2013



Clostridium difficile infection (CDI) has increased to epidemic proportions in recent years. The carriage of C. difficile among healthy adults and hospital inpatients has been established. We sought to determine whether C. difficile colonization exists among healthcare workers (HCWs) in our setting.


A point prevalence study of stool colonization with C. difficile among doctors, nurses and allied health staff at a large regional teaching hospital in Geelong, Victoria. All participants completed a short questionnaire and all stool specimens were tested by Techlab® C.diff Quik Check enzyme immunoassay followed by enrichment culture.


Among 128 healthcare workers, 77% were female, of mean age 43 years, and the majority were nursing staff (73%). Nineteen HCWs (15%) reported diarrhoea, and 12 (9%) had taken antibiotics in the previous six weeks. Over 40% of participants reported having contact with a patient with known or suspected CDI in the 6 weeks before the stool was collected. C. difficile was not isolated from the stool of any participants.


Although HCWs are at risk of asymptomatic carriage and could act as a reservoir for transmission in the hospital environment, with the use of a screening test and culture we were unable to identify C. difficile in the stool of our participants in a non-outbreak setting. This may reflect potential colonization resistance of the gut microbiota, or the success of infection prevention strategies at our institution.