Clostridium difficile: Prevention
Reducing Clostridium difficile transmission:
- Hand hygiene - adherence to hand washing recommendations and appropriate glove use will decrease carriage of Clostridium difficile on the hands of health care workers, which is one of the major modes of transmission. Soap and water is preferred to alcohol-based products when caring for persons with C. difficile infection, as the spores of C. difficile are not killed as effectively by alcohol.
- Clean environment - contaminated surfaces should be thoroughly cleaned with an agent such as bleach. Areas or objects used by multiple residents, such as commodes or telephones should also be kept clean. Avoid the sharing of patient care items such as rectal thermometers.
- Contact isolation - should be considered for persons with C. difficile infection and fecal incontinence, until the incontinence resolves.
Preventing clinical illness in people who acquire the organism
- Judicious antibiotic use is key to prevention of illness. Outbreaks of Clostridium difficile have been linked to inappropriate use of antibiotics. In one such report by Polgreen and colleagues, half of patients who received treatment for bacterial pneumonia and subsequently developed C. difficile may not have had pneumonia. In this outbreak, 5 of 15 patients died. (1)
- Investigational approaches are being studied, including vaccine development and use of probiotics.
References:
1. Polgreen PM et al. An outbreak of severe Clostridium difficile-associated disease possibly related to inappropriate antimicrobial therapy for community-acquired pneumonia. Inf Ctrl Hosp Epi 2007; 28:212-14.
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