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All About Clostridium difficile and How to Prevent It

Infections, News & Updates

Receiving medical care can put patients at risk for catching serious healthcare-associated infections (HAIs), including urinary tract infections, primary bloodstream infections, pneumonia and surgical site infections. However, one common HAI, which is caused by the pathogen clostridium difficile (C. diff), is responsible for causing approximately 12.1 percent of healthcare-associated infections. According to the CDC, nearly half a million infections are caused by C. diff within the United States each year, and in 2011, 29,000 patients died from the infection within just 30 days of their initial diagnosis. Patients who have the highest risk include those taking antibiotics while receiving medical care, older adults receiving medical care or those with a compromised immune system. With the cost of C. diff estimated to exceed more than $1.1 billion annually, it’s important for healthcare professionals and institutions to have a complete understanding of how this infection is transmitted and the actions that must be taken to protect patients and prevent the spread of C. diff.
Studies have shown that the older an individual, the more dangerous contracting an HAI can be.

What is C. diff?

Clostridium difficile, often referred to as C. diff or C. difficile, is a bacterium with the ability to cause symptoms like watery diarrhea, abdominal cramping, severe pain and life-threatening colon inflammation. Some patients may carry C. diff in their intestines and never experience symptoms, although they can still spread the infection to others. In most cases, the symptoms generally develop in five to 10 days after beginning antibiotics. Complications that may occur in patients with C. diff include kidney failure, extreme dehydration, bowel perforation, toxic megacolon and death. Even very mild or moderate C. diff infections can to progress to fatal disease if not promptly and properly treated.

How is C. diff Transmitted?

To best understand how to prevent the spread of C. diff, it’s important to learn more about how this pathogen is transmitted. C. diff has the ability to survive in a hospital environment on patient belongings, hospital equipment and hard services. While vegetative cells die rapidly, the spores produced by C. diff can live in an environment for months, and they’re also resistant to disinfection and cleaning measures. Since alcohol does not effectively kill C. diff spores, it’s very common for this infection to be transmitted to patients via a health care professional’s hands. Studies have shown that the disease may be transmitted from contaminated cellphones. One study showed that many clinicians use phones after cleaning their hands and making a short phone call is enough to contaminate hands. Many patient care activities also offer an opportunity for the transmission of C. diff, including:

  • Oral suctioning or oral care when items or hands have been contaminated
  • Environmental cleaning that is ineffective
  • Sharing of electronic thermometers used to take rectal temperatures, even when probe covers are used and probes are changed
  • Medication or meal administration
  • Poor hand hygiene
  • Various emergency procedures, including intubation
  • Computer keyboards and mice

Preventing the Spread of C. diff?

Strict infection control guidelines need to be followed by health care facilities to prevent the spread of this infection. Strategies that can be used to prevent the spread of C. diff and other HAIs include:

  • Using equipment dedicated to a specific patient, including thermometers, blood pressure cuffs, etc. Any items that are shared between patients, such as infusion pumps or glucose meters, should be thoroughly disinfected.
  • Since alcohol-based sanitizers don’t destroy C. diff spores, hand washing and wearing gloves is essential. Healthcare workers should use soap and warm water when washing their hands and wear gloves and dispose of them promptly.
  • Contact precautions should be taken to prevent the spread of C. diff. Patients who have C. diff should be isolated in a private room or share a room with another patient with the same illness. Visitors and medical professionals should wear disposable isolation gowns and gloves when in the room.
  • Routine daily cleaning with EPA-approved germicides should include cleaning:
    1. Bedside commodes
    2. The bed and other patient furniture
    3. Bathrooms
    4. Surfaces that are frequently touched, including computer touchpads, keyboards and mice, medical equipment, light switches, call bells, doorknobs, etc.
  • Educate healthcare facility personnel, including health care providers, executives and environmental services personnel.
  • Implement innovative techniques. Products like the Vioguard self-sanitizing computer keyboard, and other types of self-sanitizing equipment can be utilized to help keep healthcare spaces free from bacteria.
Preventing HAIs like C. diff can greatly reduce the burden they inflict on hospitals throughout the world.
The burden of health-care associated infections like C. diff weighs heavily on many hospitals. Reducing the prevalence of C. diff and other infections not only reduces the financial burden of these diseases, but also improves patient outcomes. Healthcare facilities must take every measure to lower the occurrences of C. diff and with the emergence of innovative technology available today, the fight against these infections is getting easier.

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