5 keys to confining C. diff

Hand-washing is critical for those who have encountered someone with Clostridium difficile (C. diff) or someone who is suspected to have contracted the bacteria, reminds the author of a newly published research article that also offers tips to help professional caregivers prevent and control the infection.

Aging adults are at high risk for the infection, points out Irena Kenneley, PhD, RN, APRN-C, CIC, a clinical nurse specialist in infection control and an associate professor at the Case Western Reserve University Frances Payne Bolton School of Nursing. Her American Journal of Nursing article, "Clostridium difficile infection is on the rise," focuses on evidence-based steps recommended by the Centers for Disease Control and Prevention (CDC) that nurses and others working in healthcare settings—including those who prepare and deliver food, clean facilities or make deliveries—can take to confine the bacteria in places where someone shows symptoms of the infection.

Based on CDC guidelines, Kenneley recommends:

1. Isolating the resident when symptoms appear (because it can take up to 96 hours to confirm a C. diff diagnosis, it is vital to isolate the potentially infected person);
2. Appropriate and timely lab testing to determine the type of bacteria present;
3. Treating with appropriate antibiotics;
4. Cleaning thoroughly (using bleach is best); and
5. Washing hands to stop the spread of further infections.

Poor hand-washing practices allow spores to travel between residents and other surfaces, Kenneley says. Hands, therefore, must be washed multiple times during the provision of care. She recommends the practice before entering a room, any time the hands touch a new surface in the room, and when exiting. Also, Kenneley says, soap is more effective than alcohol-based hand sanitizers or wipes, which do not destroy spores.

In addition to aging adults, particularly at risk for C. diff infections are people with compromised immune systems (those with HIV or who have undergone transplants, for instance), those recovering from gastrointestinal surgeries and people who are taking antibiotics for more than three days to treat other illnesses, Kenneley says.