CDC: Prevention tips for C. difficile in your practice

The CDC says a bacterial infection once thought to be limited to hospitals is spreading to practices. Find out how you can help stop it.

Is your practice contributing to the rise of Clostridium difficile (C. difficile) infections? The answer is yes, according to the U.S. Centers for Disease Control and Prevention (CDC).

C. difficile is a patient safety concern in all medical facilities, not just hospitals as traditionally thought, according to a Vital Signs report that the CDC released March 6. Although many healthcare-associated infections, such as bloodstream infections, declined in the past decade, C. difficile infection rates and deaths have climbed to historic highs.

C. difficile harms patients just about everywhere medical care is given,” said Thomas R. Frieden, MD, MPH, CDC director, in a statement. “Illness and death linked to this deadly disease do not have to happen. Patient lives can be saved when healthcare providers follow the six steps to prevention, which include key infection control and smart antibiotic prescribing recommendations.”

C. difficile is linked to about 14,000 U.S. deaths every year. Previously released estimates based on billing data show that the number of U.S. hospital stays related to C. difficile remains at its historically high level of 337,000 annually, adding at least $1 billion in healthcare costs. The Vital Signs report shows, however, that these hospital estimates may only represent one part of C. difficile’s overall impact.

Approximately one-quarter of C. difficile infections first show symptoms in hospital patients, but more than three-fourths first appear in nursing home patients or in people who recently visited doctors’ offices and clinics, according to the CDC.

The Vital Signs report shows that half of C. difficile infections diagnosed at hospitals were already present in the patient at admission, usually after getting care in other facilities.

C. difficile infections are usually a regional problem since patients transfer back and forth between facilities, allowing the disease to spread,” said L. Clifford McDonald, MD, CDC medical epidemiologist and lead author of the study. “Health departments have the ability to work with many types of health care facilities, and have a unique opportunity to coordinate local, comprehensive prevention programs to reduce the occurrence of these infections.”

The CDC recommends practices follow these C. difficile prevention tips:

Prescribe and use antibiotics carefully. About 50% of all antibiotics given are not needed. Antibiotics destroy the body's good bacteria for several months, during which time patients can get sick from C. difficile picked up from contaminated surfaces or from a healthcare provider's hands. 

Test for C. difficile when patients have diarrhea while on antibiotics or within several months of taking them.

Isolate patients with C. difficile immediately.

Wear gloves and gowns when treating patients with C. difficile, even during short visits. Hand sanitizer does not kill C. difficile, and hand washing may not be sufficient.

Clean room surfaces with bleach or another Environmental Protection Agency-approved, spore-killing disinfectant after a patient with C. difficile has been treated there.

When a patient transfers, notify the new facility if the patient has a C. difficile infection.

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