Prevalence and characteristics of toxigenic Clostridium difficile, C. perfringens and Enterococcus on shoe-bottoms from a hospital system In: American Society for Microbiology (ASM) Texas Branch Fall Meeting, (poster presentation) Oct 29-31, 2015 (SAM HOUSTON STATE UNIVERSITY, HUNTSVILLE, TX)

M. Jahangir Alam , Jacob K McPherson, Julie Miranda, Sangeetha S. Fernando, Lynn Le, Jonathan Amadio, Kevin W. Garey University of Houston College of Pharmacy


Background: Healthcare associated infections (HAI) are common everywhere in the world. Environmental surfaces are cleaned regularly, but can be re-contaminated from shoes. Shoe-bottom surfaces could be highly contaminated with pathogenic bacteria from diverse sources. Our recent studies on community house shoe-bottom surface swab samples were found to be frequently contaminated with toxigenic C. difficile. Our objectives of this pilot study were to investigate the prevalence C. difficile, C. perfringens, and Enterococcus of shoe-bottom surface swab samples from a large hospital source.

Materials and Method: We collected 20 shoe-bottom swab samples from a hospital system and cultured for the bacteria using standard methods. Isolates were characterized by molecular methods. C. difficile and C. perfringens were cultured anaerobically by enrichment and selective agar plates (CCFA and Perfringens agar). Enterococcus counts were determined by an Enterolert kit.

Results: All the samples (20/20; 100%) were positive for C. perfringens, and 9 (45%) for toxigenic C. difficile (tcdA and tcdB genes). Enterococcus counts were between 25 and >12000 cells/swab for all the samples. Vancomycin resistant Enterococcus species were recovered from 90% (18/20) the samples by selective culture using mEnterococcus agar.

Conclusions: Overall, hospital shoe-bottom samples were highly contaminated with potential human pathogens.