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In Reply We thank Crobach and colleagues for their thoughtful comments on our article.1 They raise pertinent questions regarding the mechanisms through which the detection and isolation of C difficile carriers on hospital admission could lead to a decrease in Clostridium difficile infection (CDI) rates. They suggest 3 potential mechanisms: a decrease in the progression from carriage to disease; a decrease in spread from carriers; and a decrease in spread from patients with CDI. It is difficult to ascertain which of these mechanisms may have contributed to the decrease in CDI rates in our hospital.
Longtin Y, Gilca R, Loo VG. Effect Of Detecting and Isolating Asymptomatic Clostridium difficile Carriers—Reply. JAMA Intern Med. 2016;176(10):1573. doi:10.1001/jamainternmed.2016.5342