Be alert to rise in C diff cases

Infections from Clostridium difficile have skyrocketed, more than doubling from 2000 to 2009. While most cases (75%) originate in nursing homes, doctors' offices or other health care settings, many of those C. diff patients will end up in hospitals.1 A hypervirulent, resistant strain of C. diff requires greater vigilance.

The Centers for Disease Control and Prevention is asking health care workers to be alert for signs of C. diff among patients. Patients usually have watery diarrhea but also may have fever, nausea, loss of appetite and abdominal pain and tenderness.

Employees are not at high risk for developing C. diff, which is highly associated with antibiotic use, says Clifford McDonald, MD, medical epidemiologist at CDC. However, they can help prevent the spread of the infection by wearing gloves and gowns while in patient rooms or during patient care, changing gloves between patients, and performing hand hygiene after removing gloves, he says.

Alcohol-based gels are not effective against C. diff, so in the case of an outbreak, CDC recommends using soap and water.

The usual hospital disinfectants are not effective against C. diff spores, which can persist on surfaces. CDC recommends cleaning with bleach or another EPA-approved, spore-killing disinfectant.


1. Centers for Disease Control and Prevention. Vital Signs: Preventing Clostridium difficile infections. MMWR 2012; 61:157-162.