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6 ➤ 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

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