Closeup image of gloved hands spraying surface with disinfectant for infection control

Community exposure to the superbug Clostridiodes difficile may be more common than previously thought, with a surprising amount of spores carried on the soles of shoes, a new study has found.

C. diff is associated with infectious outbreaks in long-term care facilities and hospitals. But when investigators tested samples from both healthcare and non-healthcare settings, they found that 26% of the samples in each setting tested positive for toxic strains of the bacterium. 

The soles of shoes had especially high positivity rates at 46%, suggesting that floors may play a key role in spreading C. diff contamination, investigators said.

The results highlight the importance of infection control in long-term care, such as hand washing, environmental disinfection and antibiotic stewardship to prevent the spores from reaching and infecting residents, said co-author Kevin W. Garey, Pharm.D., M.S., FASHP, of the University of Houston. 

“Our study essentially showed that the spores of C. difficile are commonly present in most environments, so that would include long-term care settings as well,” Garey said. “A disruption of the [body’s] microbiome, usually through the use of antibiotics, puts a person at risk.”

Ensuring that antibiotics are used only when necessary will help keep residents’ gut microbiomes healthy enough to prevent infection, Garey told the McKnight’s Clinical Daily.

Cases of C. diff have been decreasing in healthcare settings in recent years, but not in the community, the researchers noted. The findings underline the need to remain vigilant about control, as infections can be spread into facilities and C. diff tends to be more infectious in the elderly than in younger adults.

The findings were presented last week at the Infectious Disease Society of America’s IDWeek 2021.