Healthcare Infection Healthcare Infection Society
Official Journal of the Australasian College for Infection Prevention and Control
RESEARCH ARTICLE (Open Access)

ASID/AICA position statement – Infection control guidelines for patients with Clostridium difficile infection in healthcare settings

Rhonda L. Stuart A I , Caroline Marshall B , Mary-Louise McLaws C , Claire Boardman D , Philip L. Russo E , Glenys Harrington F and John K. Ferguson G H
+ Author Affiliations
- Author Affiliations

A Department of Infectious Diseases, Monash Medical Centre, Southern Health, Melbourne, Vic., Australia.

B Victorian Infectious Diseases Service, Royal Melbourne Hospital and Department of Medicine, University of Melbourne, Melbourne, Vic., Australia.

C Epidemiology, Hospital Infection and Infectious Diseases Control, School of Public Health and Community Medicine, The University of New South Wales, Sydney, NSW, Australia.

D Australian Infection Control Association, GPO Box 3254, Brisbane, QLD 4001, Australia.

E National Program Manager, Hand Hygiene Australia, Austin Hospital, Melbourne, Vic., Australia.

F Infection Control Consultancy (ICC), Melbourne, Vic., Australia.

G John Hunter Hospital, Newcastle, University of Newcastle, Newcastle, NSW, Australia.

H ASID Healthcare Infection Control Special Interest Group (HICSIG).

I Corresponding author. Email: Rhonda.stuart@southernhealth.org.au

Healthcare Infection 16(1) 33-39 https://doi.org/10.1071/HI11011
Submitted: 28 February 2011  Accepted: 28 February 2011   Published: 28 March 2011

Abstract

Since 2000 there has been an increase in the rates of Clostridium difficile infection (CDI) in many healthcare facilities in the United States, Canada and Europe. This increase is associated with an epidemic strain of C. difficile and this strain (PCR ribotype 027) has recently been identified in Australia. All healthcare services should have in place an optimal evidence-based program for CDI prevention and control. Management principles include the following.

• All healthcare organisations, including residential aged care facilities, must give CDI prevention and control the highest priority, even if the prevailing incidence of CDI is low.

• Surveillance should be integrated into quality improvement programs to optimise prevention, control and clinical care of CDI.

• Antimicrobial stewardship programs aimed at minimising the frequency and duration of antibiotic use and promoting a narrow spectrum antibiotic policy should be implemented.

• Emphasis should be placed on compliance with hand disinfection using alcohol-based hand rub and glove use for CDI patient care to minimise spore contamination.

• Contact precautions should be in place for symptomatic CDI patients, including the donning of gowns/aprons and gloves on entry to patient rooms.

• The use of sporocidal environmental cleaning and disinfection in high-risk areas such as toilets, bathrooms, and CDI patient rooms should be implemented. There should be the limination of other potential fomites by either using disposable equipment or ensuring that equipment is adequately cleaned and disinfected before re-use.

• Education of all healthcare staff, patients and visitors about C. difficile disease, its prevention and management should be implemented.


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