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Let’s Break it Down: C. diff 101

November 27, 2018


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You may have heard of Clostridium difficile, but do you really know what it is? You know it’s bad, you know it’s prevalent in healthcare settings, but do you know what causes it, how it’s spread or what you can do to keep your facility and its occupants safe? You should.


In honor of Clostridium difficile Awareness Month, we’re breaking down this common healthcare-associated infection (HAI) to educate those in the healthcare sector and beyond.

What is it?


Clostridium difficile (also known as C. difficile, C. diff or even CID) is a spore-forming bacterium that causes inflammation of the colon leading to watery diarrhea, fever, loss of appetite, nausea and abdominal pain and tenderness.


Mostly occurring in healthcare settings (80 percent), C. diff causes roughly half a million infections in the U.S. each year, and is becoming more frequent, severe and difficult to treat. In fact, approximately 83,000 of patients who developed C. diff in 2011 experienced at least one recurrence and 29,000 died within 30 days of the initial diagnosis.


The infection is most prevalent in those who have been taking antibiotics for a prolonged amount of time as antibiotics work really well at killing germs. Unfortunately they work too well, also killing off the good, infection-fighting germs that keep our insides healthy.



How is it spread?


C.diff bacteria are found in feces, so its transmission can be spread by ineffectively washed hands or from a surface that hasn’t been cleaned effectively after contamination. Although C. diff is most commonly found in healthcare settings, food and food-prep surfaces can also be contaminated if handled by someone with poorly washed hands. Some people can even carry the C. diff bacterium in their intestines but never become sick, unknowingly spreading the infection to others.



How do you treat it?


C.diff is very persistent infection and in roughly 20 percent of patients, the infection will return. Because of this, treatment depends on the patient and can range from starting a round of antibiotics, stopping a current antibiotic or even a stool transplant in cases of chronic recurrence.



How do you prevent it?


Three common and effective prevention techniques are cleaning, patient isolation and handwashing:


1. Cleaning


C. diff is a hearty bacterium that refuses to be killed by just any cleaning product, making its eradication somewhat difficult. Even though its vegetative cells die within 24 hours outside the colon, the C. diff spores can live for up to five months on hard surfaces and are highly resistant to cleaning and disinfection measures. That’s why it’s essential to select a solution that can kill both C. diff vegetative cells and its spores.


But even when using an effective cleaning solution, dilution and dwell-time are essential so be sure to follow the cleaning product directions carefully.


2. Isolation


When in a hospital setting, it is recommended that infected patients be isolated in a private room with their own toilet to decrease transmission. Even if a patient is only suspected to have a C. diff infection, isolation is recommended until test results can be confirmed to limit the chance of transmission to others.


3. Handwashing


Perhaps the most important step in the prevention and management of C. diff and other HAIs is frequent and effective handwashing. Hospital staff in particular should adhere to specific hand hygiene protocols such as the World Health Organization’s (WHO) “5 Moments for Hand Hygiene,” to ensure patients safety and prevent room to room transmission:


  1. When entering a patient room, apply an effective hand sanitizer to decrease transient bacteria and reduce the risk of cross-contamination between patient rooms. 
  2. Clean hands before performing any type of aseptic procedure to protect the patient against harmful pathogens. This can include germs carried by the healthcare professional or living on the patient’s own body. 
  3. Clean hands after exposure to, or the threat of exposure to, bodily fluids, including your own. This can be something as innocent as a sneeze. This will protect not only the patient, but the healthcare workers caring for the patient and help to limit the spread of infection-causing pathogens both in the room and between rooms. 
  4. Clean hands after touching a patient or any of the patient’s immediate surroundings, such as the patient’s clothes or gown, hospital bed, exam chair, remote, call button, etc. 
  5. Clean hands after touching any object in the patient’s room, such as high-touch surfaces such as door handles, bed railings, chairs, countertops, etc.  


5 moments


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