New Clostridium difficile guidelines will make a real difference says HPSC


The Health Protection Surveillance Centre today (Thursday) published national expert guidelines for the surveillance, diagnosis and management of Clostridium difficile to help healthcare professionals combat the disease.

These recommendations will make a real difference in healthcare facilities around the country and their publication follows requests from infection control teams for national guidelines, says HPSC consultant microbiologist, Dr Fidelma Fitzpatrick, who chaired the committee which was responsible for providing the advice.

"Today's publication comes after the recent decision to make Clostridium difficile a notifiable disease from 4th May 2008. Ireland is one of the first countries to take this step and it means that cases must be reported, providing more information about Clostridium difficile and its prevalence.

"Clostridium difficile can be a serious and potentially fatal infection and is the single biggest cause of diarrhoea in patients who have had antibiotic therapy. While most infections take place in hospitals and nursing homes it can also occur in the community. Most of those affected are elderly patients with underlying illnesses.

"Although some people can be healthy carriers, it mostly spreads from one person to another through direct contact. Diarrhoea caused by Clostridium difficile can contaminate the general environment around patients' beds, toilet areas, sluices, commodes, bed pan washers and the like. Spores can survive for a long time and can be a source of hand-to-mouth infection, especially for other patients who have also been given antibiotics.

"The three most important factors in preventing and controlling Clostridium difficile are:

  • Sensible prescribing of antibiotics to reduce the use of broad spectrum antibiotics
  • Isolation of patients with Clostridium difficile diarrhoea, and good infection control practices including washing hands with soap and water (not relying solely on alcohol gel as this does not kill the spores) and wearing gloves and aprons, especially when dealing with bed pans etc.
  • Enhanced environmental cleaning of patient care areas. The use of chlorine containing disinfectant, or other sporocidal disinfectant, is generally recommended."