From the Guidelines
Yes, Clostridioides difficile (C. diff) is contagious, and it spreads primarily through the fecal-oral route when people touch surfaces contaminated with feces containing C. diff spores and then touch their mouths. The most recent and highest quality study, published in 2019 in the World Journal of Emergency Surgery 1, emphasizes the importance of hand hygiene with soap and water as the cornerstone of prevention of C. difficile infection. This study highlights that alcohol-based hand sanitizers are highly effective against non-spore-forming organisms, but they do not kill C. difficile spores or remove C. difficile from the hands.
Key measures to prevent the spread of C. diff include:
- Thorough handwashing with soap and water, especially after caring for patients with CDI or using the bathroom
- Using contact precautions, such as gloves and gowns, when caring for patients with CDI
- Implementing daily environmental sporicidal disinfection and terminal disinfection of rooms of patients with CDI
- Restricting the use of antibiotic agents/classes that can contribute to the development of CDI
- Educating healthcare workers on prevention strategies for CDI
According to the 2019 study 1, the use of sodium hypochlorite solutions for environmental cleaning and disinfection is recommended in patient areas where C. difficile transmission is ongoing. Additionally, the study suggests that newer alternatives for environmental decontamination, such as hydrogen peroxide vapor (HPV) and UV decontamination, may be effective in reducing CDI rates.
It is essential to note that the European Society of Clinical Microbiology and Infectious Diseases (ESCMID) study group for C. difficile (ESGCD) recommends using personal protective equipment, contact precautions, and daily environmental sporicidal disinfection to decrease transmission of C. difficile and reduce the incidence of CDI 1.
In terms of treatment, patients diagnosed with C. diff should take all prescribed medications, typically vancomycin, fidaxomicin, or metronidazole for 10-14 days, and practice good hygiene, including frequent handwashing and cleaning of shared bathroom facilities with bleach-based products 1.
Overall, the key to preventing the spread of C. diff is to prioritize hand hygiene with soap and water, implement contact precautions, and maintain a clean environment through sporicidal disinfection.
From the Research
Contagiousness of C-Diff
- C-Diff, or Clostridioides difficile, is a bacterium that can cause intestinal symptoms and is often associated with hospital-acquired infections 2, 3.
- The bacterium can be spread through contaminated surfaces, healthcare workers, and infected patients 4.
- C-Diff infections can be severe and even life-threatening, especially in older adults and those with weakened immune systems 5, 6.
- The primary mode of transmission is through the fecal-oral route, where spores of the bacterium are ingested, often through contaminated food, water, or surfaces 3, 4.
Prevention and Treatment
- Prevention measures include proper hand hygiene, use of personal protective equipment, and thorough cleaning and disinfection of surfaces 2, 3.
- Treatment options for C-Diff infections include antibiotics, such as vancomycin and fidaxomicin, as well as fecal microbiota transplantation (FMT) 2, 3, 5, 6.
- FMT has been shown to be effective in treating recurrent C-Diff infections, with success rates of over 85% 4, 6.
Risk of Transmission
- The risk of transmission of C-Diff is higher in healthcare settings, where the bacterium can spread quickly through contaminated surfaces and healthcare workers 3, 4.
- Patients with C-Diff infections should be isolated to prevent the spread of the bacterium to others 5.
- Healthcare workers should follow proper infection control protocols, including hand hygiene and use of personal protective equipment, to prevent the transmission of C-Diff 2, 3.