One in 10 hospital patients who develop Clostridioides difficile infections may already have the dangerous germ when admitted, but no diarrhea symptoms, a new study finds.

The new report suggests that such infections originate outside hospitals more often than believed, and that patients could be screened to prevent the spread of C. difficile, according to the authors.

Each year, more than 400,000 cases of C. difficile that result in nearly 30,000 deaths are reported in the United States, according to a 2015 report.

In this study, researchers tested 220 patients who showed no symptoms of C. difficile infection when they were admitted to a New York hospital between July 2017 and March 2018. Patients were followed for six months.

At admission, 21 patients were identified as carriers of C. difficile.

Within six months, 38% of carriers developed symptomatic C. difficile infection, compared with 2% of noncarriers, according to the study published recently in the journal Infection Control & Hospital Epidemiology.

The findings suggest many people carry undetected C. difficile and may pass it on to others and/or develop an infection themselves, said lead author Dr. Sarah Baron. She's an assistant professor of medicine at Albert Einstein College of Medicine in New York City.

"It has generally been assumed that patients get the bacteria during their stay in the hospital," she said in a journal news release. "However, when we tested patients being admitted to the hospital, we found that many of them were carrying the bacteria that causes this diarrhea in their bodies already and often went on to develop the infection."

Baron said the findings might mean that hospitals will one day be able to predict who will develop C. difficile and try to stop it before it starts.

"More work is needed to determine how we can protect everyone, even the patients who already have the bacteria in their colons, from developing this dangerous form of diarrhea," Baron said.

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