Clostridium difficile infection: an update for infection control practitioners

Clostridium difficile is a common healthcare-associated infection that causes significant patient morbidity and mortality, as well as adding to the cost of healthcare. Almost all cases follow the use of antibiotics, and the major reservoir of infection is infected patients in hospitals or long-term care facilities. The emergence of a novel strain of C. difficile (NAP1/BI/027) around the world has been associated with increased frequency, severity and relapse of C. difficile disease. Principles of C. difficile prevention include antibiotic stewardship, monitoring of incidence and outbreaks, appropriate use of contact precautions, accurate identification of infected patients, consistent hand hygiene and improved environmental cleaning. A variety of surveillance systems and definitions have been used to monitor infection rates. Recently published internationally recognised recommendations and definitions support implementation of an appropriate surveillance program in Australia, endorsed by the Australian Health Ministers Conference in 2008.