Clinical features, management and infection control of Clostridium difficile infection in an Australian tertiary hospital: a prospective observational study

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Contents Vol 16(4)

doi:10.1071/HI11026

Official Journal of the Australasian College for Infection Prevention and Control

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Clinical features, management and infection control of Clostridium difficile infection in an Australian tertiary hospital: a prospective observational study

Genevieve McKew ^A ^B and Kate Clezy ^A

^A Department of Infectious Diseases, Prince of Wales Hospital, Randwick, NSW 2031, Australia.
^B Corresponding author. Email: genevieve.mckew@sswahs.nsw.gov.au

Healthcare Infection 16(4) 140-145 http://dx.doi.org/10.1071/HI11026
Submitted: 18 October 2011 Accepted: 10 December 2011 Published: 16 January 2012





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Abstract

Objective: Clostridium difficile infection (CDI) is a significant cause of antibiotic-associated diarrhoea and is associated with significant morbidity and mortality. This prospective, observational study of CDI aims to describe its clinical features and management in an Australian tertiary hospital and adherence to infection control procedures by staff.

Methodology: Twenty-six subjects over the age of 18 years with a positive test for C. difficile were included in the study. Subjects were interviewed at 0, 7 and 30 days with regard to risk factors, duration of symptoms, severity of illness and outcomes. Details of management were extracted from the medical record, and laboratory parameters were recorded. Adherence to infection control procedures was observed.

Results: Subjects had severe and debilitating disease, with a mortality of 18% at 30 days. The median duration of symptoms was 12 days, and the median length of hospital stay was 31 days. Medical monitoring for complications of the disease was not optimal. Eighty percent of patients were treated in accordance with recommendations in the Australian Antibiotic Guidelines. There was reasonable adherence to isolation and use of personal protective equipment after CDI was diagnosed, but not when it was suspected. Adherence to the guidelines for hand hygiene was poor.

Conclusions: CDI causes severe and morbid disease in hospitalised patients. Adherence to infection control needs to be improved. Consideration should be given to a pilot study of monitoring rates and outcomes of CDI in Australian hospitals.

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