Clostridium Difficile C'diff: - PowerPoint PPT Presentation

1 / 18
About This Presentation
Title:

Clostridium Difficile C'diff:

Description:

C. diff is a bacteria that lives in the intestinal tract of about 5% of healthy adults ... CDAD is sometimes called antibiotic ... How is C. diff transmitted? ... – PowerPoint PPT presentation

Number of Views:166
Avg rating:3.0/5.0
Slides: 19
Provided by: ccbh
Category:

less

Transcript and Presenter's Notes

Title: Clostridium Difficile C'diff:


1
Clostridium Difficile (C.diff)
  • Fast Facts

2
What is Clostridium difficile (C. diff)?
  • C. diff is a bacteria that lives in the
    intestinal tract of about 5 of healthy adults
  • C.diff-associated disease (CDAD) occurs when the
    normal intestinal flora is altered which allows
    the bacteria to grow and produce disease causing
    toxin. CDAD is sometimes called antibiotic
    associated diarrhea

3
What are the main clinical symptoms of CDAD?
  • Common symptoms include watery diarrhea
    (sometimes with blood or pus), fever, loss of
    appetite, nausea, and abdominal pain.
  • Complications can include pseudomembranous
    colitis, toxic megacolon, perforations of the
    colon, sepsis, and sometimes death.

4
How is C. diff transmitted?
  • C. diff is shed in feces and can contaminate high
    contact surfaces such commodes, thermometers,
    bed-side tables, etc.
  • C.diff is often spread to patients on the hands
    of health care workers or other people who touch
    a contaminated surface.

5
(No Transcript)
6
Who gets CDAD?
  • Anyone taking antibiotics very few people who
    are not on antibiotics get CDAD
  • Persons with inflammatory bowel diseases
  • Persons who have had gastrointestinal surgery
  • Persons on chemotherapy

7
Diagnosis and Treatment
  • Residents with diarrhea should have a stool
    specimen tested for C.diff. Testing is not
    recommended for people with no symptoms (i.e.
    screening or test for cure)
  • DO NOT USE ANTI-DIARRHEALS
  • Treatment
  • Stop antibiotics, if possible (23 of cases
    resolve in 2-3 days)
  • If diarrhea continues, try Flagyl or Vancomycin

8
Why all the recent attention?
  • Reports of CDAD disease have increased, noting
    more severe disease and an associated increase in
    mortality.
  • The increased rates and/or severity of disease
    may be caused by changes in antibiotic use,
    changes in infection control practices, or the
    emergence of a new strain of C.
    difficile-associated disease with increased
    virulence and/or antimicrobial resistance.

9
How can CDAD be prevented in our facility?
  • Use antibiotics judiciously
  • Use Contact Precautions for patients with CDAD
  • If possible, place these patients in private
    rooms or place in rooms (cohorted) with other
    patients with C. difficile-associated disease.
  • Use gloves when entering patients rooms and
    during patient care.
  • Use gowns if soiling of clothes is likely.
  • Dedicate equipment whenever possible. If not
    possible, disinfect equipment between patients.
  • Precautions should be continued until diarrhea
    has ceased.
  • Wash hands with SOAP and WATER before and after
    caring for patients.

10
How can CDAD be prevented in our facility
(cont.)?
  • Implement an environmental cleaning and
    disinfection strategy
  • Use an Environmental Protection Agency
    (EPA)-registered hypochlorite-based disinfectant
    for environmental surface disinfection after
    cleaning in accordance with label instructions
    generic sources of hypochlorite (e.g., household
    chlorine bleach) also may be appropriately
    diluted and used. (Note alcohol-based
    disinfectants are not effective against C.
    difficile and should not be used to disinfect
    environmental surfaces.)

11
A Word on Reporting
  • Facility based reporting January 1, 2006-
    December 31, 2006
  • Case Definitions
  • Health Care-Associated (Initial) Positive
    laboratory diagnostic test, endoscopy or biopsy
    gt48 hours after admission to a health care
    facility.
  • Health Care-Associated (Recurrent) Subsequent
    positive laboratory diagnostic test, endoscopy or
    biopsy in an individual with a previous health
    care-associated positive within the prior 6
    months. A subsequent infection which occurs gt6
    months after an initial infection is also
    classified as an initial infection.

12
Reporting (cont.)
  • Patient Days Reporting
  • Reported monthly
  • Total Patient Days Sum of the daily census over
    the entire month
  • Ex. 12 on the 1st 12 on the 2nd 13 on the
    31st Total Patient Days for the Month

13
Further Recommendations
  • Form an Infection Control Committee
  • Post signs reminding staff, visitors, and
    residents to wash their hands
  • Provide inservices for staff on infectious
    disease and control measures

14
Reportable Infectious Diseases in Ohio
  • Refer to the list of reportable diseases and the
    Northeast Ohio Communicable Disease Report form
    in your packet.
  • Cuyahoga Central Disease Reporting
  • phone 216-201-2080
  • fax 216-676-1316

15
Educational Resources
  • ODH will be offering infection control courses
    through APIC (EPI 101 EPI 201)
  • Courses will take place in Toledo, Columbus, and
    Cambridge
  • Go to www.apic.org for course descriptions
  • Dates and times will be sent out later

16
Hospital C.diff Rateswww.odh.state.oh.us
  • Initial Rate (cases per 10,000)
  • Jan - 8
  • Feb - 8
  • Mar - 7
  • Apr - 8
  • May 8
  • June 7
  • Recurrent Rate (cases per 10,000)
  • Jan - 2
  • Feb - 2
  • Mar - 2
  • Apr - 2
  • May 2
  • June - 2

17
Add Safe Environment Info
18
Thank you for your time and attention.
  • www.ccbh.net
  • 216.201.2020 (option 2)
Write a Comment
User Comments (0)
About PowerShow.com