Research Article| Volume 69, ISSUE 5, P456-461, November 2014

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A detection dog to identify patients with Clostridium difficile infection during a hospital outbreak


      • Early and rapid identification of Clostridium difficile infections (CDI) is important to prevent transmission.
      • A detection dog had high diagnostic accuracy (sensitivity 86%; specificity 97%) for bedside diagnosis of CDI patients.
      • For 2 CDI negative patients the dog repeatedly indicated a positive response; both did prove CDI positive weeks later.
      • More research is needed to see if the use of sniffer dogs can lead to a quicker diagnosis, and improve outbreak management.



      Early and rapid identification of Clostridium difficile infections (CDI) is important to prevent transmission. In this study we assessed the diagnostic accuracy of a trained detection dog for detecting CDI cases on hospital wards in an outbreak setting.


      During a CDI outbreak in a large Dutch university hospital, we screened affected hospital wards repeatedly with a trained detection dog. The dog's response was compared to the clinical diagnosis, supported by laboratory results.


      During a total of 9 hospital visits, the dog performed 651 screenings involving 371 participants. The dog correctly identified 12 out of 14 CDI cases [sensitivity 86% (95% confidence interval (CI): 56–97%)] and 346 out of 357 CDI negative participants [specificity of 97% (95% CI: 94–98%)]. Interestingly, of the 11 CDI negative participants that were ‘falsely’ indicated by the dog as positive, 2 (18%) did actually developed CDI during the 3 months of follow-up after the detection period; compared to only 12 of the 346 participants (3.5%) that the dog identified as C. difficile negative (p = 0.06).


      A trained detection dog can accurately detect CDI in hospitalized patients during an outbreak. A (repeated) positive dog response is a strong indication of a CDI episode coming, be it the next day or possibly up to a month.


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