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Using Clinical & Molecular Research to Prevent Clostridium difficile Infection

ID/IIDR Combined Rounds: Dr. Marek Smieja & Dr. Andrew McArthur

 

Clostridium difficile bacterium. Image © Adobe Stock

Clostridium difficile (C. diff) is a globally increasing infection that causes toxic and often severe damage to the colon. As virtually all cases follow recent antibiotic use – and most are directly or indirectly health care-associated – the spread and prevention of C. diff is a topic of great clinical importance. IIDR investigators Dr. Marek Smieja & Dr. Andrew McArthur combined their unique skill sets in clinical practice and molecular research to explore the pattern of hospital associated C. diff infection spread during this Fall’s first Michael G. DeGroote Institute for Infectious Disease Research (IIDR) and Infectious Diseases Division Combined Joint Rounds.

Dr. Smieja began the rounds with a description of clinical cases of C. diff and the unique challenges to control this pathogen in the hospital setting. A series of clinical interventions including long-term antibiotic use and prophylaxis were presented. This clinical exposé set the stage for a discussion of recent work by Dr. McArthur. In collaboration with Public Health Ontario and St. Joseph’s Healthcare Hamilton, Dr. McArthur’s lab along with colleagues in McMaster’s Farncombe Family Digestive Health Research Institute applied whole genome sequencing and data rich molecular epidemiology techniques on patient isolates from four Ontario hospitals. They were able to identify the large diversity of C. diff clonal groups apparent throughout and pinpoint which groups gave rise to healthcare associated outbreaks. Such results offer invaluable epidemiological knowledge that can ultimately improve the advancement of C. diff infection prevention and control within healthcare settings.

This type of cross-disciplinary collaboration offered through the IIDR and the ID Division not only contributes to the understanding of bacterial infection spread and prevention on a global scale, but offers a unique learning experience to both biomedical researchers and clinical trainees. “My students get to see their work reflected from the patient end” stated Dr. McArthur, who believes that this type of exposure to clinical research can help young researchers see first-hand the value and application of their work efforts.

Future efforts are already in discussion between Dr. Smieja and Dr. McArthur, who hope to continue fostering their cross-disciplinary collaboration by further applying their screening program to identify C. diff outbreaks potentially arising from asymptomatic carriers – an additional area of clinical importance, as over a third of hospital associated C. diff cases are acquired through asymptomatic shedding (contamination from C. diff patients without key diagnostic symptoms).

“This is the beginning something really fantastic” stated IIDR director Gerry Wright, who believes that the IIDR Combined Joint Rounds initiative can help foster new relationships between clinicians and biomedical researchers – collaborations that are essential in closing the gap between clinical input and translational output.

IIDR Combined Joint Rounds are presented on the first Wednesday of every month at the McMaster University Medical Centre, and are open to all IIDR members and trainees.

Click on the link to view the 2017-2018 ID/IIDR Rounds Schedule.