The authors declare that they have no financial conflicts of interest.
Infection control measures to limit the spread of Clostridium difficile
Version of Record online: 11 APR 2008
© 2008 The Authors. Journal Compilation European Society of Clinical Microbiology and Infectious Diseases
Clinical Microbiology and Infection
Special Issue: Infection control measures to limit the spread of Clostridium difficile
Volume 14, Issue Supplement s5, pages 2–20, May 2008
How to Cite
Vonberg, R.-P., Kuijper, E. J., Wilcox, M. H., Barbut, F., Tüll, P., Gastmeier, P., on behalf of the European C. difficile-Infection Control Group and the European Centre for Disease Prevention and Control (ECDC), Van Den Broek, P. J., Colville, A., Coignard, B., Daha, T., Debast, S., Duerden, B. I., Van Den Hof, S., Van Der Kooi, T., Maarleveld, H. J. H., Nagy, E., Notermans, D. W., O’Driscoll, J., Patel, B., Stone, S. and Wiuff, C. (2008), Infection control measures to limit the spread of Clostridium difficile. Clinical Microbiology and Infection, 14: 2–20. doi: 10.1111/j.1469-0691.2008.01992.x
- Issue online: 11 APR 2008
- Version of Record online: 11 APR 2008
- Clostridium difficile;
- evidence-based guidelines;
- infection control measures
Clostridium difficile-associated diarrhoea (CDAD) presents mainly as a nosocomial infection, usually after antimicrobial therapy. Many outbreaks have been attributed to C. difficile, some due to a new hyper-virulent strain that may cause more severe disease and a worse patient outcome. As a result of CDAD, large numbers of C. difficile spores may be excreted by affected patients. Spores then survive for months in the environment; they cannot be destroyed by standard alcohol-based hand disinfection, and persist despite usual environmental cleaning agents. All these factors increase the risk of C. difficile transmission. Once CDAD is diagnosed in a patient, immediate implementation of appropriate infection control measures is mandatory in order to prevent further spread within the hospital. The quality and quantity of antibiotic prescribing should be reviewed to minimise the selective pressure for CDAD. This article provides a review of the literature that can be used for evidence-based guidelines to limit the spread of C. difficile. These include early diagnosis of CDAD, surveillance of CDAD cases, education of staff, appropriate use of isolation precautions, hand hygiene, protective clothing, environmental cleaning and cleaning of medical equipment, good antibiotic stewardship, and specific measures during outbreaks. Existing local protocols and practices for the control of C. difficile should be carefully reviewed and modified if necessary.