C. diff is a spore-forming, Gram-positive anaerobic bacillus that produces two exotoxins: toxin A and toxin B. It is a common cause of antibiotic-associated diarrhea (AAD) and accounts for 15 to 25% of all episodes of AAD. Show
The risk for disease increases in patients with:
C. diff is shed in feces. Any surface, device, or material (such as commodes, bathtubs, and electronic rectal thermometers) that becomes contaminated with feces could serve as a reservoir for the C. diff spores. C. diff spores can also be transferred to patients via the hands of healthcare personnel who have touched a contaminated surface or item. Although in about 20% of patients, CDI will resolve within two to three days of discontinuing the antibiotic to which the patient was previously exposed, CDI should usually be treated with an appropriate course (about 10 days) of treatment, including oral vancomycin or fidaxomicin. After treatment, repeat C. diff testing is not recommended if the patient’s symptoms have resolved, as patients often remain colonized. If a patient has had ≥ 3 stools in 24 hours:
If the patient is positive for CDI:
CDI can be prevented by using antibiotics appropriately and implementing infection control recommendations to prevent transmission.
Surfaces should be kept clean, and body substance spills should be managed promptly, as outlined in CDC’s Guidelines for Environmental Infection Control in Health-Care Facilities. Routine cleaning should be performed prior to disinfection. EPA-registered disinfectants with a sporicidal claim have been used with success for environmental surface disinfection in those patient-care areas where surveillance and epidemiology indicate ongoing transmission of C. diff. Note: EPA-registered disinfectants (List K) are recommended for use in patient-care areas. When choosing a disinfectant, check product labels for inactivation claims, indications for use, and instructions. Is C. diff airborne or droplet?C. difficile was isolated from the air in the majority of these cases (7 of 10 patients tested) and from the surfaces around 9 of the patients; 60% of patients had both air and surface environments that were positive for C. difficile.
What precautions are taken for C. diff?Contact Precautions. Use gloves and gown when entering patients' rooms and during patient care. Remove PPE and perform hand hygiene when exiting the room.. Change gloves and gowns and perform hand hygiene when moving from one patient to another when patients are cohorted, and before leaving patient room.. What type of isolation does C. diff require?When caring for patients with Clostridioides difficile hospitals and nursing homes will: Place patients with Clostridioides difficile infection in a private room whenever possible. Place the patient in Contact Precautions, also known as isolation.
How is C. diff usually transmitted?C. difficile bacteria and their spores are found in feces. People can get infected if they touch surfaces contaminated with feces, and then touch their mouth. Healthcare workers can spread the bacteria to their patients if their hands are contaminated.
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