C. difficile spores resist desiccation for months and are known to persist on hard surfaces for up to five months. Spores persist even after exposure to air. Epidemic strain BI/NAP1/027 is known to hyper-sporulate, a virulence-associated characteristic of outbreak strains.
Health care workers are important vectors for transmission, as they may carry the spores on their hands or clothing. Alcohol-based hand sanitizers are very effective against non-sporulating organisms but do not kill C. difficile spores or remove the organism from the hands. The CDC recommends thorough hand washing using soap and water for caregivers and family members alike.
Patients with C. difficile infection (CDI) should be isolated to a single room with a bathroom or roomed together.
Staff treating infected patients should use personal protective equipment (PPE), including at least gowns and gloves, and must wash hands after removing gloves. The use of gowns helps to prevent contamination of clothing.
Surfaces should be decontaminated using a solution of 10% sodium hypochlorite (bleach), this is effective in reducing environmental contamination in hospital rooms. The CDC recommends the use of bleach for cleaning patient and staff rooms during outbreaks.
Control strategies involving reinforcement of infection control practices rather than drug restriction are more effective. These practices include:
- Proper education of staff members involved in the care of CDI patients
- Better isolation compliance
- Use of gloves
- Frequent and thorough hand washing
- Environmental decontamination
