Infection Control Guidelines for C. Difficile
This is a draft cheat sheet. It is a work in progress and is not finished yet.
At least 25 percent of antibiotic prescriptions in nursing homes do not meet clinical guidelines for prescribing. This use and overuse of antibiotics results in side effects and drug-resistant bacteria. The Communication and Decisionmaking for Four Infections toolkit aims to reduce inappropriate prescribing for the four infections for which antibiotics are most frequently prescribed in nursing homes:
(1) Urinary tract infections (UTIs)
(2) Lower respiratory tract infections
(3) Skin and soft tissue infections
(4) Gastrointestinal infections
When to Perform Toxin Assay on Stool
Resident symptomatic with diarrhea ( >3 loose/watery stools a day).
Especially consider in residents who received antibiotics in previous 60 days and have one or more of the following: fever, elevated WBC, fecal leukocytes, abdominal pain/tenderness.
Do not perform toxin assay on formed stool.
Do not culture stool; only perform toxin assay.
After treatment, do not retest for cure (toxin may stay positive even when resident is improved).
When to Treat
Symptomatic resident with toxin-positive stool.
How to Isolate Culture-positive Residents
Limit time outside of room for C. difficile positive resident while symptomatic; limit time especially if resident is unable to contain stool.
Use gloves for contact with resident or resident’s environment while on therapy.
Perform hand hygiene with soap and water (alcohol does not kill C. difficile spores).
Consider daily use of diluted hypochlorites (household bleach diluted 1:10 with water) to disinfect resident’s environment.
C. difficile bacteria wreak havoc in guts
Pathogenesis of Clostridium difficile
From Colonization to Infection