How to Prevent C difficile Infection: A New Guide

Laura A. Stokowski, RN, MS


May 24, 2013

In This Article

The Frustrating Problem of CDI

Healthcare professionals are frustrated with Clostridium difficile, an enteric pathogen that continues to produce epidemics of infection despite efforts to stop its spread in healthcare facilities and the community. In January 2013, the Association for Healthcare Professionals in Infection Control and Epidemiology (APIC) surveyed 14,000 members in the United States (1087 responded) to ask about C difficile infection (CDI) rates and prevention activities. The Pace of Progress Survey[1] revealed that despite stepped-up efforts by 70% of respondents, CDI rates aren't falling proportionally. Only 42% of respondents have seen an improvement in CDI rates in the past 3 years.[1]

CDI: Preventing the Preventable

A comprehensive new guidance document from APIC, "Guide to Preventing Clostridium difficile Infections,"[2] aims to translate current science into best practices for implementation by teams of healthcare professionals with the goal of preventing CDI (Figure).The guide emphasizes the multifaceted approach mandated by the current epidemic.

Figure. APIC's "Guide to Preventing Clostridium difficile Infections."

"We hope that the guide will stimulate thought on the part of healthcare facilities," says Ruth M. Carrico, PhD, RN and lead author of the guide. "This is not a 1-person or a 1-group problem. Preventing CDI requires many different individuals with different skill sets. The staff who provide the care, those who clean the environment, and the providers who order the antibiotics must all be included as part of the solution. Preventing CDI also takes leadership to bring together all of the knowledge about CDI and lead the implementation of changes in practice."

The guide offer a logical sequence of information and recommendations, including the epidemiology of CDI and how CDI is transmitted from person to person, appropriate diagnostic methods, how to conduct surveillance of CDI, and detailed suggestions for how to prevent CDI in healthcare facilities and the community. Other sections cover important topics, such as prevention of CDI in skilled nursing facilities and the key role of antimicrobial stewardship. "The most important message about CDI today is that it is preventable," said guide contributor Brandi Limbago, MD, of the Centers for Disease Control and Prevention.


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