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➤ Accommodate patients with CDI in a private room with a dedicated
toilet to decrease transmission to other patients. If there is a
limited number of private single rooms, prioritize patients with stool
incontinence for placement in private rooms (S-M).
➤ If cohorting is required, it is recommended to cohort patients infected
or colonized with the same organism(s) — i.e., do not cohort patients
with CDI who are discordant for other multidrug resistant organisms
such as methicillin resistant Staphylococcus aureus (MRSA) or
vancomycin resistant enterococcus (S-M).
➤ Healthcare personnel must use gloves (S-H) and gowns (S-M) on entry
to a room of a patient with CDI and while caring for patients with CDI.
➤ Patients with suspected CDI should be placed on pre-emptive contact
precautions pending the C. difficile test results if test results cannot
be obtained on the same day (S-M).
➤ Continue contact precautions for at least 48 hours after diarrhea has
resolved (W-L).
➤ Prolong contact precautions until discharge if CDI rates remain high
despite implementation of standard infection control measures
against CDI (W-L).
➤ In routine or endemic settings, perform hand hygiene before and after
contact with a patient with CDI and after removing gloves with either
soap and water or an alcohol-based hand hygiene product (S-M).
➤ In CDI outbreaks or hyper-endemic (sustained high rates) settings,
perform hand hygiene with soap and water preferentially instead of
alcohol-based hand hygiene products before and after caring for a
patient with CDI, given the increased efficacy of spore removal with
soap and water (W-L).
➤ Handwashing with soap and water is preferred if there is direct
contact with feces or an area where fecal contamination is likely,
e.g., the perineal region (GP).
➤ Encourage patients to wash hands and shower to reduce the burden
of spores on the skin (GP).
➤ Use disposable patient equipment when possible and ensure
that reusable equipment is thoroughly cleaned and disinfected,
preferentially with a sporicidal disinfectant that is equipment
compatible (S-M).
Infection Prevention and Control
