Clostridium difficile is an anaerobic gram-positive bacterium that forms spores. These bacteria produce toxins and cause opportunistic infections. Clostridium difficile bacteria produce A and B toxins. It accounts for 15%-25% of all episodes of antibiotic-associated diarrhea. A new strain of Clostridium difficile that is more virulent was isolated recently. Its high virulence is related to the production of a larger level of toxins (Maja and Nelson 3).
The major reservoirs of clostridium difficile bacteria are individuals infected or colonized by these bacteria. Also, a contaminated environment is perfect for Clostridium difficile bacteria. Clostridium difficile spores can survive on the surfaces for weeks and months. Rectal thermometers and bathing tubs are examples of materials and devices that, when contaminated with infected feces, can act as Clostridium difficile reservoirs (Kyne 129).
Defecation is a portal of exit for Clostridium difficile spores. It is shed in the stool of symptomatic and asymptomatic people. After spores shedding, they contaminate hands, bathroom fixtures, floor surfaces, and incontinent individuals, such as hospital staff.
Clostridium difficile is transmitted through feces. Examples of materials that transmit Clostridium difficile spores include feces, contaminated rectal thermometers, and bathing tubs (Maja and Nelson 3). Health workers should observe aseptic techniques to avoid transmitting Clostridium difficile spores to patients. Ingestion is a portal of entry for Clostridium difficile spores. This happens when an individual picks up spores from environmental surfaces. Patients should wash their hands before meals. Additionally, health personnel should thoroughly clean rooms before new patients come to prevent Clostridium difficile infection. Susceptible hosts include individuals on broad-spectrum antibiotics, immune-compromised individuals, surgical patients, those on treatment, and the elderly (Kelly 78).
Some of the necessary precautions against Clostridium difficile include all staff and visitors washing their hands when entering and leaving patients’ rooms. Gloves and gowns are effective measures in preventing the spread of Clostridium difficile spores. It is, therefore, recommended that health staff and visitors go to attending patients to put on gloves and gowns to minimize the chances of spreading these spores. Signs should be placed outside the Clostridium difficile patients’ rooms for precaution purposes. Before sending patients for laboratory tests or treatment, health workers must wash their hands, wear gowns and gloves (“CDC: Frequently Asked Questions” par. 4).
There are various ways to break the Clostridium difficile chain of infection. To break the chain at the reservoir stage, it is necessary for staff, patients, and visitors to wash their hands. Health institutions should provide disposable hand wash clothes. They should have dedicated staff, necessary equipment, washroom, and commode. Infected patients should be provided with private rooms and cohorts. Also, they should be restricted from bedroom movement to limit spore spreading. Rapid treatment with antibiotics is vital for identified cases. To break the link at the portal of exit level terminal room cleaning is required. In addition, patients’ movement around the facility should be limited. Health personnel should carefully change bed linen and wash their hands after assisting patients (Maja and Nelson 5).
To break the link at the mode of transmission level carefully remove curtains and change bed linen to avoid spreading spores. The susceptible host should not share a room with a known suspect of Clostridium difficile infection. Beds and rooms should be thoroughly cleaned before placing new patients. Cleaning the room twice a day and hand washing is essential.
To break the link at the portal of entry it is recommended to clean any utensils and thermometers before putting them into the mouth. Avoid storing food from patient trays in the communal fridge. Health institutions should provide disposable hand wash clothes to those with mobility problems before meals. Staff and visitors should wash their hands before entering and after leaving the patient’s room. Also, patients should wash their hands before meals.
To break the link at susceptible hosts’ level avoid placing new patients in the room previously occupied by Clostridium difficile, unless proper terminal cleaning has been done. The use of broad-spectrum antibiotics should be controlled. Visitors and staff should wash their hands before or on entry to the patient’s room. Public education on ways to prevent Clostridium difficile infections is necessary. Additionally, hand washing before meals or snacks is recommended.
Standard precautions are the basis of preventing Clostridium difficile transmission through promoting infection control practices. Consistent use of these precautions offers the greatest potential for preventing transmission of Clostridium difficile infection. One of the keys recommended precautions in preventing the spreading of clostridium spores is observing hand hygiene. The latter preventive measure cuts down chances of passing clostridium spores to other environments or people. Hand washing and not using alcohol based hand rubs is recommended in the presence of Clostridium difficile (Owens 305).
Contact precautions entail use of gloves and gowns when attending to individuals infected with Clostridium difficile. Regular hand washing is a vital step in reducing the risk of transmitting Clostridium difficile spores. After removal and appropriate discarding of gloves and gown, hands should be washed immediately with soap and water in order to physically remove Clostridium difficile spores through friction, lather and rinsing. Some of hand cleaning detergents such as iodophors, alcohol, and chlorhexidine do not completely kill Clostridium difficile spores (Kyne 134).
Works Cited
CDC: Frequently Asked Questions 2005. Web.
Kelly, Canon. “Clostridium Difficile: More Difficult than Ever.” New England Journal of Medicine 35.1 (2008): 77-96. Print.
Kyne, Lisbon. “Clostridium Difficile: Beyond Antibiotics.” New England Journal of Medicine14.1 (2010): 129-134. Print.
Maja, Wilcox, and Dale Nelson. “Clostridium Difficile Infection: New Developments in Epidemiology and Pathogenesis.” Nature Reviews Microbiology 7.2 (2009): 2-15. Print.
Owens, Richard. “Clostridium difficile Associated Disease: An emerging Threat to Patient Safety.” Pharmacotherapy Journal 26.3 (2006): 299-311. Print.