Table 1 The elements of Clostridioides difficile healthcare epidemiology

1. At the time of hospitalization 10.6% of patients (range 2.8–21%) are CD carriers

Ref: [25,26,27,28,29,30,31,32,33,34,35]

2. During hospitalization 12.5% of patients (range 2.9–21%) are CD carriers

Ref: [25, 36,37,38,39,40,41]

3. Transmission of CD spores to environmental surfaces is associated with:

Ref: [46,47,48]

Patients with acute infection

Patients recovering from acute infection

Asymptomatic CD colonized patients

4. Treatment does not decrease ongoing environmental spore contamination for more than a month

Ref: [49]

5. Wide spread surface contamination far from known CD infected patients

Ref: [35, 36]

6. Increased Cleaning and disinfection result in:

Ref: [99]

Decreased surface and hand contamination

Decreased CD acquisition

7. Genomic confirmation of the role of asymptomatic CD carriers in transmission

Ref: [37, 42,43,44,45]

8. Acquisition of CD from a prior room occupant is significantly dependent on the prior room occupant receiving antibiotics

Ref: [52, 53]