Best’s Flushing Caution; Sandoe on Dog-Snogging

From Leeds comes news of how to literally keep down infectious material in hospitals:

Potential for aerosolization of Clostridium difficile after flushing toilets: the role of toilet lids in reducing environmental contamination risk,” E.L. Best, J.A. Sandoe and M.H. Wilcox,  Journal of Hospital Infections, epub December 1, 2011.  The authors, at Leeds General Infirmary and the University of Leeds, report:

Background:  Toilet facilities in healthcare settings vary widely, but patient toilets are commonly shared and do not have lids. When a toilet is flushed without the lid closed, aerosol production may lead to surface contamination within the toilet environment.

Methods: We performed in-situ testing….

Findings: C. difficile was recoverable from air sampled at heights up to 25 cm above the toilet seat. The highest numbers of C. difficile were recovered from air sampled immediately following flushing, and then declined 8-fold after 60 min and a further 3-fold after 90 min…. C. difficile aerosolization and surrounding environmental contamination occur when a lidless toilet is flushed.

Conclusion: Lidless conventional toilets increase the risk of C. difficile environmental contamination, and we suggest that their use is discouraged, particularly in settings where CDI is common.

Coauthor Jonathan Sandoe is famed, in some circles, for one of his previous studies:

Do Not Snog the Dog: Infective Endocarditis Due to Capnocytophaga canimorsus,” Dumbor L. Ngaage, Konstantinos N. Kotidis, Jonathan A.T. Sandoe, R. Unnikrishnan Nair, European Journal of Cardio-Thoracic Surgery, vol. 16, no. 3, 1999, pp. 362-3. The authors write:

“We present a case of prosthetic valve endocarditis and paravalvular abscess caused by the canine bacteria Capnocytophaga canimorsus in a 63-year-old man, who made a habit of snogging his pet dog. Capnocytophaga canimorsus can cause culture-negative endocarditis, therefore a high level of clinical awareness and the appropriate isolation techniques are important for making the diagnosis. Antibiotic therapy and properly timed excision of the infected focus are recommended.”

(Thanks to investigator Adrian Smith for bringing both reportsto our attention.)