{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,26]],"date-time":"2026-09-26T05:27:56Z","timestamp":1790400476235,"version":"4.1.0"},"reference-count":28,"publisher":"Oxford University Press (OUP)","funder":[{"DOI":"10.13039\/100006380","name":"US Department of Veterans Affairs Office of Research and Development","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100006380","id-type":"DOI","asserted-by":"publisher"}]},{"name":"VA SeqCURE"},{"name":"American Rescue Plan Act"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Admission to a room previously occupied by a person with Clostridioides difficile infection (CDI) has been identified as a risk factor for CDI. However, previous studies have not included molecular typing to definitively link healthcare-associated CDI (HA-CDI) cases to prior room occupants.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>In a hospital and affiliated long-term care facility, we conducted a 1-year cohort study to determine if exposure to a room previously occupied by a person with CDI and\/or with environmental contamination after cleaning and disinfection in the past 3 months was associated with an increased risk of HA-CDI. Multivariable logistic regression was used to assess risk factors for HA-CDI. Whole genome sequencing was used to determine the relatedness of HA-CDI isolates and isolates from prior CDI cases or environmental surfaces.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Of the 5746 people admitted, 55 were diagnosed with HA-CDI. Exposure to a room previously occupied by a person with CDI and\/or with a positive postdischarge culture was not associated with an increased risk of HA-CDI (adjusted odds ratio 1.15, 95% CI .65\u20131.98; P = .62). None of the 21 HA-CDI patients with prior room-level exposures were infected with isolates genomically related to isolates from prior room occupants with CDI or from room surfaces. Five HA-CDI cases were linked to prior people with CDI or environmental isolates on the same ward or without ward-level exposure.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Despite frequent exposure to rooms previously occupied by people with CDI or contaminated with C. difficile, no HA-CDI cases were linked to prior room exposures in a facility using sporicidal disinfectants in CDI rooms.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/cid\/ciag547","type":"journal-article","created":{"date-parts":[[2026,9,5]],"date-time":"2026-09-05T13:54:44Z","timestamp":1788616484000},"source":"Crossref","is-referenced-by-count":1,"title":["Use of Whole Genome Sequencing to Investigate the Risk for Transmission of\n                    <i>Clostridioides difficile<\/i>\n                    From Prior Room Occupants: A Single-Center Study"],"prefix":"10.1093","author":[{"given":"Sarah N","family":"Redmond","sequence":"first","affiliation":[{"name":"Department of Medicine, Case Western Reserve University School of Medicine , Cleveland, Ohio ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria M","family":"Torres-Teran","sequence":"additional","affiliation":[{"name":"Research Service, Louis Stokes Cleveland VA Medical Center , Cleveland, Ohio ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jennifer L","family":"Cadnum","sequence":"additional","affiliation":[{"name":"Research Service, Louis Stokes Cleveland VA Medical Center , Cleveland, Ohio ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0004-5468-1910","authenticated-orcid":false,"given":"Claire E","family":"Kaple","sequence":"additional","affiliation":[{"name":"Department of Molecular Biology and Microbiology, Case Western Reserve University School of Medicine , Cleveland, Ohio ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Samir","family":"Memic","sequence":"additional","affiliation":[{"name":"Research Service, Louis Stokes Cleveland VA Medical Center , Cleveland, Ohio ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Munok","family":"Hwang","sequence":"additional","affiliation":[{"name":"Department of Medicine (CJ) and Department of Research (HC, PC, MH), Central Texas Veterans Healthcare System , Temple, Texas ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hosoon","family":"Choi","sequence":"additional","affiliation":[{"name":"Department of Medicine (CJ) and Department of Research (HC, PC, MH), Central Texas Veterans Healthcare System , Temple, Texas ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7655-0485","authenticated-orcid":false,"given":"Piyali","family":"Chatterjee","sequence":"additional","affiliation":[{"name":"Department of Medicine (CJ) and Department of Research (HC, PC, MH), Central Texas Veterans Healthcare System , Temple, Texas ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3916-952X","authenticated-orcid":false,"given":"Chetan","family":"Jinadatha","sequence":"additional","affiliation":[{"name":"Department of Medicine (CJ) and Department of Research (HC, PC, MH), Central Texas Veterans Healthcare System , Temple, Texas ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0990-4498","authenticated-orcid":false,"given":"Curtis J","family":"Donskey","sequence":"additional","affiliation":[{"name":"Department of Medicine, Case Western Reserve University School of Medicine , Cleveland, Ohio ,","place":["USA"]},{"name":"Infectious Diseases Section, Louis Stokes Cleveland VA Medical Center , Cleveland, Ohio ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2026,9,9]]},"reference":[{"key":"2026092513261517900_ciag547-B1","doi-asserted-by":"crossref","first-page":"527","DOI":"10.1017\/ice.2023.18","article-title":"Strategies to prevent Clostridioides difficile infections in acute-care hospitals: 2022 update","volume":"44","author":"Kociolek","year":"2023","journal-title":"Infect Control Hosp Epidemiol"},{"key":"2026092513261517900_ciag547-B2","doi-asserted-by":"crossref","first-page":"201","DOI":"10.1086\/658669","article-title":"Evaluation of hospital room assignment and acquisition of Clostridium difficile infection","volume":"32","author":"Shaughnessy","year":"2011","journal-title":"Infect Control Hosp Epidemiol"},{"key":"2026092513261517900_ciag547-B3","doi-asserted-by":"crossref","first-page":"1352","DOI":"10.1016\/j.ajic.2022.02.006","article-title":"Clostridioides difficile infection (CDI) in a previous room occupant predicts CDI in subsequent room occupants across different hospital settings","volume":"50","author":"Sood","year":"2022","journal-title":"Am J Infect Control"},{"key":"2026092513261517900_ciag547-B4","doi-asserted-by":"crossref","first-page":"599","DOI":"10.1017\/ice.2023.254","article-title":"The role of the hospital bed in hospital-onset Clostridioides difficile: a retrospective study with mediation analysis","volume":"45","author":"Witt","year":"2024","journal-title":"Infect Control Hosp Epidemiol"},{"key":"2026092513261517900_ciag547-B5","doi-asserted-by":"crossref","first-page":"652","DOI":"10.1016\/j.ajic.2025.01.010","article-title":"Does routine use of sporicidal disinfectants for all post-discharge hospital rooms reduce environmental contamination with Clostridioides difficile spores?","volume":"53","author":"Cadnum","year":"2025","journal-title":"Am J Infect Control"},{"key":"2026092513261517900_ciag547-B6","doi-asserted-by":"crossref","first-page":"777","DOI":"10.1017\/ice.2017.76","article-title":"A multicenter randomized trial to determine the effect of an environmental disinfection intervention on the incidence of healthcare-associated Clostridium difficile infection","volume":"38","author":"Ray","year":"2017","journal-title":"Infect Control Hosp Epidemiol"},{"key":"2026092513261517900_ciag547-B7","doi-asserted-by":"crossref","first-page":"909","DOI":"10.1017\/ice.2018.106","article-title":"Transmission of Clostridium difficile from asymptomatically colonized or infected long-term care facility residents","volume":"39","author":"Donskey","year":"2018","journal-title":"Infect Control Hosp 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(the benefits of enhanced terminal room disinfection study): a cluster-randomised, multicentre, crossover study","volume":"389","author":"Anderson","year":"2017","journal-title":"Lancet"},{"key":"2026092513261517900_ciag547-B14","doi-asserted-by":"crossref","first-page":"35","DOI":"10.1093\/cid\/ciab896","article-title":"Ultraviolet-C light evaluation as adjunct disinfection to remove multidrug-resistant organisms","volume":"75","author":"Rock","year":"2022","journal-title":"Clin Infect Dis"},{"key":"2026092513261517900_ciag547-B15","first-page":"1024","article-title":"Lowering the acquisition of multidrug-resistant organisms (MDROs) with pulsed-xenon (LAMP) study: a cluster-randomized, controlled, double-blinded, interventional crossover trial","volume":"79","author":"Dhar","year":"2024","journal-title":"Clin Infect Dis"},{"key":"2026092513261517900_ciag547-B16","doi-asserted-by":"crossref","first-page":"1801","DOI":"10.1093\/cid\/ciz189","article-title":"Are many patients diagnosed with healthcare-associated Clostridioides difficile infections colonized with the infecting strain on admission?","volume":"69","author":"Gonzalez-Orta","year":"2019","journal-title":"Clin Infect Dis"},{"key":"2026092513261517900_ciag547-B17","doi-asserted-by":"crossref","first-page":"1076","DOI":"10.1017\/ice.2020.1367","article-title":"Timing and route of contamination of hospitalized patient rooms with healthcare-associated pathogens","volume":"42","author":"Redmond","year":"2021","journal-title":"Infect Control Hosp Epidemiol"},{"key":"2026092513261517900_ciag547-B18","doi-asserted-by":"crossref","first-page":"397","DOI":"10.1128\/JCM.01591-08","article-title":"Effective and reduced cost modified selective medium for isolation of Clostridium difficile","volume":"47","author":"Nerandzic","year":"2009","journal-title":"J Clin Microbiol"},{"key":"2026092513261517900_ciag547-B19","doi-asserted-by":"crossref","first-page":"3259","DOI":"10.1128\/JCM.00793-14","article-title":"Sensitive 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after a switch from a dilutable quaternary ammonium disinfectant to a ready-to-use wipe product","volume":"54","author":"Cadnum","year":"2026","journal-title":"Am J Infect Control"},{"key":"2026092513261517900_ciag547-B28","doi-asserted-by":"crossref","first-page":"ciag364","DOI":"10.1093\/cid\/ciag364","article-title":"Clostridioides difficile infection deceleration: what is next?","author":"Gerding","year":"2026","journal-title":"Clin Infect Dis"}],"container-title":["Clinical Infectious 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