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Clostridium difficile Infections: Diagnosis, Treatment, and Prevention

Slide: 30 of 33

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.