Infection Control

Clostridium Difficile

What is Clostridium Difficile (C DIFF)?

C diff is one of the many germs (bacteria) that can be found in stool (a bowel movement).

What is C Diff Disease?

C diff disease occurs when antibiotics kill your good bowel bacteria and allow the C diff to grow. When C diff grows, it produces substances (toxins). These toxins can damage the bowel and may cause diarrhea. C diff disease is usually mild but sometimes can be severe. In severe cases, surgery may be needed and in extreme cases C diff may cause death. C diff is the most common cause of infectious diarrhea in hospital. The main symptoms of C diff disease are:

• Watery diarrhea
• Fever 
• Abdominal pain or tenderness 

Who Gets C Diff?

C diff disease usually occurs during or after the use of antibiotics. Old age, presence of other serious illnesses and poor overall health may increase the risk of severe disease.

How Will Your Doctor Know That You Have C Diff?

If you have symptoms of C diff, your doctor will ask for a sample of your watery stool. The laboratory will test the stool to see if C diff toxins are present.

How is C Diff Treated?

Treatment depends on how sick you are with the disease. People with mild symptoms may not need treatment. For more severe disease, an antibiotic is given.

How Does C Diff Spread?

When a person has C diff disease the germs in the stool can soil surfaces such as toilets, handles, bedpans, or commode chairs. When touching these items our hands can become soiled. If we then touch our mouth we can swallow the germ. Our soiled hands also can spread the germ to other surfaces.

How to Prevent Spread in the Hospital?

If you have C diff diarrhea you will be moved to a private room until you are free from diarrhea for at least 2 days. Your activities outside the room will be restricted. Everyone MUST clean their hands when leaving your room.

Always wash your hands after using the bathroom. Cleaning hands is the most important way for everyone to prevent the spread of this germ. As well, a thorough cleaning of your room and equipment will be done to remove any germs.

What Should I Do at Home?

Healthy people like your family and friends who are not taking antibiotics are at very low risk of getting C diff disease.

Hand care
Wash you hands for 15 seconds:

 

• After using the toilet
• After touching dirty surfaces
• Before eating
• Before preparing meals.

 

Cleaning the house
Use either a household cleaner diluted according to the instructions or diluted household bleach:

 

• Wet the surface well and clean using good friction
• Allow the surface to air dry
• Pay special attention to areas that may be soiled with stool such as the toilet and sink. If you see stool remove first and then clean as described above.

 

Cleaning clothes/other fabric
Wash clothes/fabric separately if they are heavily soiled with stool:

 

• Rinse stool off
• Clean in a hot water cycle with soap
• Dry items in the dryer if possible.

 

Cleaning Dishes: 
Regular cleaning, you can use the dishwasher or clean by hand with soap and water.

It is very important that you take all your medication as prescribed by your doctor. You should not use any drugs from the drugstore that will stop your diarrhea (e.g. Imodium). If diarrhea persists or comes back, contact your doctor.

Helpful Resources 

 

• Learn more about Clostridium Difficile Disease 

 

Vancomycin Resistant Enterococcus (VRE)

What is VRE?

Enterococci are germs that live in the gastrointestinal tract (bowels) of most individuals and generally do not cause harm (this is termed "colonization"). Vancomycin-resistant enterococci (VRE) are strains of enterococci that are resistant to the antibiotic vancomycin. If a person has an infection caused by VRE, such as a urinary tract infection or blood infection, it may be more difficult to treat.

How is VRE spread?

VRE is spread from one person to another by contact, usually on the hands of caregivers. VRE can be present on the caregiver's hands either from touching contaminated material excreted by an infected person or from touching articles soiled by feces. VRE can survive well on hands and can survive for weeks on inanimate objects such as toilet seats, taps, door handles, bedrails, furniture and bedpans. VRE is easy to kill with the proper use of disinfectants and good hand hygiene.

What special precautions are required for VRE?

It is important that special precautions are taken to stop VRE from spreading to other patients in the hospital. These precautions include:

• Single room accommodation (the door can remain open)
• A long-sleeved gown and gloves must be worn by everyone who cares for you
• A sign may be placed on your door to remind others who enter your room about the special precautions
• The room and the equipment used in the room will be cleaned and disinfected regularly
• Everyone who leaves your room must clean their hands well
• You must wash your hands before you leave your room

What about family/visitors?

Your family and visitors should not assist other patients with their personal care as this may cause the germ to spread. They may be required to wear a long-sleeved gown and gloves while in your room. Before leaving your room, visitors must remove the gloves and gown and dispose of them in the garbage container and the linen hamper located in your room. Then they must clean their hands.

Good Hand Hygiene Practices:

Remind all staff and visitors to practice good hand hygiene before and after they touch you. Ask your nurse or doctor to demonstrate proper hand hygiene techniques (15 seconds of soap and running water OR waterless alcohol hand rub until hands are dry).

You need to clean your hands:

• After using the bathroom
• After blowing your nose
• Before eating and drinking
• Before and after you touch your dressing or wounds
• When your hands are visibly dirty (soiled)
• Before you leave your room

What will happen at home?

If you have VRE at the time of discharge from hospital, the chance of spreading the germ to your family is small. But, we do recommend you practice the following:

• Everyone who might help you with your personal hygiene or with going to the toilet should wash his/her hands after contact with you.
• Wash your hands before you make any food and before you eat; everyone in the household should follow this household.
• Wash your hands well after using the toilet. Make sure others that use the bathroom wash their hands well afterwards.
• Clothing may be laundered in the same manner as the rest of the household laundry.
• No special cleaning of furniture or items (e.g. dishes) in the home is required.
• If you share a bathroom at home, clean the toilet and sink at least weekly with a germicidal cleanser.
• Always tell your physician, paramedics, nurses or other care providers that you have VRE. This helps prevent spread to others.

Methicillin-Resistant Staphylococcus Aureus (MRSA)

What is MRSA?

Staphylococcus aureus is a germ that lives on the skin and mucous membranes of healthy people. Occasionally S. aureus can cause an infection. When S. aureus develops resistance to certain antibiotics, it is called Methicillin-Resistant Staphylococcus Aureus, or MRSA.

How is MRSA spread?

MRSA is spread from one person to another by contact, usually on the hands of caregivers. MRSA can be present on the caregiver's hands either from touching contaminated material excreted by the infected person or from touching articles contaminated by the skin of a person with MRSA, such as towels, sheets and wound dressings. MRSA can live on hands and objects in the environment.

What special precautions are required for MRSA?

It is important that special precautions are taken to stop MRSA from spreading to other patients in the hospital. These precautions include:

 

• Single room accommodation (the door can remain open).
• A long-sleeved gown and gloves must be worn by everyone who cares for you.
• A sign may be placed on your door to remind others who enter your room about the special precautions.
• The room and the equipment used in the room will be cleaned and disinfected regularly.
• Everyone who leaves your room must clean their hands well.
• You must clean your hands before you leave your room.

 

What about family/visitors?

Your family and visitors should not assist other patients with their personal care as this may cause the germ to spread. They may be required to wear a long-sleeved gown and gloves while in your room. Before leaving your room, visitors must remove the gloves and gown and dispose of them in the garbage container and the linen hamper located in your room. Then they must clean their hands.

Good Hand Hygiene Practices:

Remind all staff and visitors to practice good hand hygiene before and after they touch you. Ask your nurse or doctor to demonstrate proper hand hygiene techniques (15 seconds of soap and running water OR waterless alcohol hand rub until hands are dry). You need to clean your hands:

 

• After using the bathroom.
• After blowing your nose.
• Before eating and drinking.
• Before and after you touch your dressing or wounds.
• When your hands are visibly dirty (soiled).
• Before you leave your room.

 

What will happen at home?

If you have MRSA at the time of discharge from hospital, the chance of spreading the germ to your family is small. But, we do recommend that you practice the following:

 

• Everyone who might help you with your personal hygiene or with going to the toilet should wash his/her hands after contact with you.
• Wash your hands before you make any food and before you eat; everyone in the household should follow this practice.
• Wash your hands well after using the toilet. Make sure others that use the bathroom wash their hands well afterwards.
• Clothing may be laundered in the same manner as the rest of the household laundry. No special cleaning of furniture or items (e.g. dishes) in the home is required.
• Always tell your physician, paramedics, nurses or other care providers that you have MRSA. This helps prevent spread to others.

 

Hand hygiene refers to removing or killing microorganisms on the hands as well as maintaining good skin integrity.

Hand Hygiene Fact Sheet