Clostridium difficile Infections: Diagnosis, Treatment, and Prevention
Institutional Prevention Strategies for CDI
One controlled trial examined the use of gloves to prevent C. difficile transmission, with CDI incidence monitored by active surveillance. Incidence of CDI and asymptomatic C. difficile carriage decreased significantly on the intervention wards but not on the control wards. Three studies, have shown that use of disposable thermometers prevent CDI. Ten studies provide low evidence that disinfection with a chemical compound that kills C. difficile spores in the hospital environment prevents CDI, at least in epidemic or hyperendemic settings. No study addressed whether handwashing was associated with reduced CDI incidence. Many institutions encourage the use of alcohol-based rubs or gels for hand hygiene unless hands are grossly soiled or unless a health care worker has had potential contact with C. difficile either from patient contact or environmental contamination. Neither alcohol nor soap will kill C. difficile spores, but when health care workers wash hands properly with soap, most spores are removed because of friction and the detergent action of soap.
- Brooks S, Khan A, Stoica D, et al. Reduction in vancomycin-resistant Enterococcus and Clostridium difficile infections following change to tympanic thermometers. Infect Control Hosp Epidemiol 1998 May; 19(5):333-6.
- Brooks SE, Veal RO, Kramer M, et al. Reduction in the incidence of Clostridium difficile-associated diarrhea in an acute care hospital and a skilled nursing facility following replacement of electronic thermometers with single-use disposables. Infect Control Hosp Epidemiol 1992 Feb; 13(2):98-103.
- Butler M, Bliss D, Drekonja D, Filice G, Rector T, MacDonald R, Wilt T. Effectiveness of Early Diagnosis, Prevention, and Treatment of Clostridium difficile Infection. Comparative Effectiveness Review No. 31 (Prepared by the Minnesota Evidence-based Practice Center under Contract No. 290-02-0009.) AHRQ Publication No. 11(12)-EHC051-EF. Rockville, MD. Agency for Healthcare Research and Quality. December 2011. Available at: http://www.effectivehealthcare.ahrq.gov/index.cfm/search-for-guides-reviews-and-reports/?pageaction=displayproduct&productID=772.
- Jernigan JA. A randomized crossover study of disposable thermometers for prevention of Clostridium difficile and other nosocomial infections. Infect Control Hosp Epidemiol 1998; 19(7):494-9.
- Johnson S, Gerding DN, Olson MM, et al. Prospective, controlled study of vinyl glove use to interrupt Clostridium difficile nosocomial transmission. Am J Med 1990 Feb; 88(2):137-40.
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