Infection Control

Study confirms C. diff can travel through the air

Briefings on Infection Control, August 1, 2010

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Precautions remain the same, but early isolation is reinforced

As Clostridium difficile (C. diff) began appearing in many hospitals across the country—and subsequently has become more problematic than its more popular antibiotic companion, MRSA—the primary concern was surface decontamination, since C. diff spores contaminated many high-touch areas.

But a study published in the June Clinical Infectious Diseases discovered that C. diff spores could travel through the air, something many experts believed was possible but which had not been scientifically proven. 

“The results at one level are not surprising in that it was always predictable that you could isolate C. diff if you looked for it adequately, but people haven’t done that previously. So it does document that C. diff is dispersed into the air, and particularly it would appear early on in the infection,” says Mark Wilcox, BMedSci, BMBS, MD, professor of medical microbiology at the Institute of Molecular and Cellular Biology at the University of Leeds (UK) and lead author of the study.

More importantly, says Wilcox, it gives IPs more evidence regarding the importance of early detection and implantation of prevention methods concerning patients with C. diff infections. 

Controlling transmission

There are two main schools of thought regarding preventing transmission of C. diff infections, says Wilcox.

The first is controlling the prescription of antibiotics, since many antibiotics contribute to the growth of an infection. Many hospitals in the United States have already implemented antibiotic stewardship programs to reduce the amount of antibiotics and offer alternatives. 

The second approach is controlling transmission, which involves isolation of patients with potential or confirmed C. diff infections. 

Wilcox says the best approach is a combination, with transmission prevention on the first tier, followed by a sound antibiotics stewardship program. 

“If you concentrate, as traditionally some people have, on the antibiotic, then it doesn’t matter what I prescribe to some extent, you’re not going to induce a C. diff infection without the transmission,” Wilcox says. “So the key intervention is limiting the transmission, and then the good antibiotic usage or prescribing comes on top of that, but not before. If that’s what you concentrate on, and yet you’ve got poor infection control practice, you’ll still be spreading the organism around.”

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