Clostridioides difficile, formerly Clostridium difficile, is the leading cause of infectious diarrhea and one of the most common healthcare acquired infections in United States hospitals. C. difficile persists well in healthcare environments because it forms spores that can survive for long periods of time and can be transmitted to susceptible patients through contact with contaminated hands and fomites, objects or surfaces that can harbor infectious agents. Fomites can be classified as high-touch or low-touch based on the frequency they are contacted.

The mathematical model in this study investigates the relative contribution of high-touch and low-touch fomites on new cases of C. difficile colonization among patients of a hospital ward. The dynamics of transmission are described by a system of ordinary differential equations representing four patient population classes and two pathogen environmental reservoirs. Parameters that have a significant effect on incidence, as determined by a global sensitivity analysis, are varied in stochastic simulations of the system to identify feasible strategies to prevent disease transmission.

Results indicate that on average, under one-quarter of asymptomatically colonized patients are exposed to C. difficile via low-touch fomites. In comparison, over three-quarters of colonized patients are colonized through high-touch fomites, despite additional cleaning of high-touch fomites. Increased contacts with high-touch fomites increases the contribution of these fomites to the incidence of colonized individuals and decreasing the duration of a hospital visit reduces the amount of pathogen in the environment. Thus, enhanced efficacy of disinfection upon discharge and extra cleaning of high-touch fomites, reduced contact with high-touch fomites, and higher discharge rates, among other control measures, could lead to a decrease in the incidence of colonized individuals.

艰难梭菌，前身为艰难梭菌，是感染性腹泻的主要原因，也是美国医院最常见的医疗获得性感染之一。艰难梭菌在医疗保健环境中持续存在，因为它形成的孢子可以长时间存活，并且可以通过接触受污染的手和可能含有传染性病原体的污染物、物体或表面传播给易感患者。Fomites 可以根据接触的频率分为高接触或低接触。

本研究中的数学模型调查了高接触和低接触污染物对医院病房患者新的艰难梭菌定植病例的相对贡献。传播动力学由代表四个患者群体类别和两个病原体环境库的常微分方程系统描述。由全局敏感性分析确定的对发病率有显着影响的参数在系统的随机模拟中有所不同，以确定预防疾病传播的可行策略。

结果表明，平均而言，不到四分之一的无症状定植患者通过低接触污染物接触艰难梭菌。相比之下，尽管对高接触污染物进行了额外的清洁，但超过四分之三的定植患者是通过高接触污染物定植的。与高接触污染物的接触增加会增加这些污染物对定植个体的发病率的贡献，并且减少医院就诊的持续时间会减少环境中病原体的数量。因此，提高出院时的消毒效果和对高接触污染物的额外清洁、减少与高接触污染物的接触以及提高出院率等控制措施，可能会导致定植个体的发病率下降。