Download Section: 2-1

Infection Prevention and Control – Clostridium Difficile Infection
Strength of Evidence Level: 3
PURPOSE:
To protect patients and agency staff from transmission
of Clostridium difficile infection (CDI).
CONSIDERATIONS:
1. CDI can range from uncomplicated diarrhea to
sepsis and even death.
2. C. difficile is a spore forming bacteria.
3. C. difficile is shed in feces. Any surface, device or
material that becomes contaminated with feces may
serve as a reservoir for the C.difficile spore.
4. C. difficile transmission occurs via the fecal-oral
route via the hands of healthcare workers who have
touched a contaminated surface or item.
5. CDI is increasing in incidence and severity and may
be becoming more difficult to treat.
6. If a patient has CDI, the clinician must assess for
disease progression and follow infection control
guidelines to prevent spread.
7. The infection can usually be treated with an
appropriate course of antibiotics; including,
metronidazole or vancomycin (usually reserved for
severe cases or relapses) administered orally.
8. After treatment, repeat C. difficile testing is not
recommended if the patient’s symptoms have
resolved; the patient may remain colonized.
9. Use contact precautions for patients with known or
suspected CDI.
10. Perform hand hygiene using soap and water if
feasible (Alcohol based hand rubs are not as
effective against spore-forming bacteria.).
11. C-difficile spores can be highly resistant to routine
disinfectants and can survive on surfaces for many
weeks or months. Bleach (1:10 dilution made fresh
daily) is the appropriate disinfectant.
EQUIPMENT:
Gloves
Antimicrobial soap
Paper towels
Gowns, aprons as indicated
PROCEDURE:
1. Use contact precautions for all patients with known
or suspected CDI.
2. Continue precautions until diarrhea has resolved for
about 48 hours.
AFTER CARE:
1. Instruct patient and caregivers on best way of
cleaning and disinfecting their environmental
surfaces and reusable devices like commodes,
toilets, bathroom surfaces.
2. Instruct patients or caregivers on signs and
symptoms of CDI and to observe for relapses.
SECTION: 14.05
__RN__LPN/LVN__HHA
REFERENCES:
APIC Guide to Elimination of Clostridium difficile. (2003).
HICPAC Guidelines for Environmental Infection Control
in Health-Care Facilities. 52(No.RR-10).