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The Clostridium Difficile Infection Concept

Clostridium difficile infection (CDI) levels in America increased tremendously between 2000 and 2005 with an upsurge in the disease mortality and morbidity, especially amid the aged individuals (Goldstein et al., 2015). It is evident that there is a necessity for more successful management and prevention approaches to decrease the prevalence and severity of the infection. Control methods for the disease entail the avoidance of the intake of the disease-causing organism and minimizing the likelihood of getting infected in case the pathogens get into the body. Ways of preventing the infection entail the traditional disease control approaches that focus on the environment, a person’s hygiene, and barrier techniques while the means of minimizing the possibility of developing the disease mainly concentrate on the reduction or eradication of antimicrobial exposure, especially when the application of agents is not necessary. Reducing the likelihood of infection is usually referred to as good antimicrobial stewardship.

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Hand Hygiene

Hand hygiene represents a vital action that is recommended for the prevention and reduction of the spread of pathogens in an effort of making sure that patients stay safe and that the risk of getting the infection is reduced. Hand hygiene acts as a fundamental activity for every medical practitioner and other stakeholders, including members of the family, in an attempt of protecting the patients and oneself. There are often two methods used in making sure that hand hygiene is helpful. One method involves handrubbing with the use of alcohol-anchored handrub; this is the best way of ensuring hand hygiene in every occasion except the ones necessitated for soap and water. Moreover, this method is recommended for health professionals in their routine, daily cleaning of hands. The second method is washing hands with soap and water (Kundrapu, Sunkesula, Jury, Deshpande, & Donskey, 2014). The use of soap and water plays a key role in ensuring hand hygiene and ought to be used in cases where hands are evidently dirty or contaminated with body fluids such as blood, after visiting the toilet, and following exposure to pathogens, encompassing times of diarrhea epidemic.

CDI bacterium is naturally existent in the bowel of most people. It may be transmitted through contact with fecal matter and then touching one’s mouth, for instance, while eating (Landelle et al., 2014). If a person uses antibiotics to treat the infection, they might eradicate different forms of bacteria in the bowel, both the useful and harmful ones. In such a situation, CDI may grow fast in the bowel and generate toxins that cause the disease. The pathogens that cause the infection are present in the feces of the infected individuals, encompassing spores that can survive for a very long period in different environments, for example, areas near the toilet, clothes, and furniture to mention a few. This happens if such places are not frequently and thoroughly cleaned. It is likely for people to transmit the infection by not performing proper hand hygiene or by failing to maintain the patient’s environs clean. Aged people, individuals with bowel problems, and patients who have comorbidities are particularly at a high risk of developing the infection.

Environmental Management, Staff Hygiene, and Barrier Techniques

Every health facility ought to assess the severity and degree of hospital-based CDI infection diligently as a section of its disease control programs to easily establish whether such levels are tolerable and swiftly discover the best means of addressing augments in the prevalence and mortality. Comparing the levels within a health facility to degrees at other infirmaries for benchmarking is made difficult by the range of measures employed in monitoring the infection, encompassing lab findings (that is, positive tests). Even in cases where probable scrutiny is carried out, dissimilar case descriptions and decontaminators are usually employed making the generation of situation comparators impracticable. Some of the interventions that have been proved successful in the interruption of disease transmission are sterilization using hypochlorite to reduce environmental infectivity and application of successful barriers (especially gloves) while attending patients to avoid getting infected (Landelle et al., 2014).

Keeping patients in areas earlier occupied by others who had drug-resistant infection has been established to leave them at high risk of developing similar infections. This illustrates that the environment acts as a crucial basis of contamination that facilitates the potential for transmission of CDI infection. The environment harbors the spores that cause diseases such as CDI for a long time. Since such spores could be present in feces, the surfaces that get contaminated with fecal matter function as reservoirs.

In wards and critical care units at a health institution, CDI contamination has been established in 48% of areas in rooms housing patients with the disease and 28% of the units harboring asymptomatic carriers (Dubberke et al., 2014). The biggest proportion of contaminants remains on floors and bedrails; toilets, bedding, and sills of windows are other places where CDI causing pathogens hide. The consequence of contaminants within the surroundings cannot be underscored adequately since it has been determined that as the degree of environmental contamination rises, the incidence of CDI hand carriage amid medical practitioners increases. On this note, the health professionals and others caregivers become a significant vector for the spread of the pathogens.

The normally employed cleansing agents in health facilities, for instance, quaternary ammonium-anchored detergents might actually promote monogenesis (Surawicz et al., 2013). Furthermore, the epidemic form of CDI, which is greatly affecting the majority of regions in North America as well as some areas in Europe, has been found to hypersporulate, making it a high-risk strain. Studies have established that hypersporulation is a virulence-linked trait of epidemic strains of CDI. The existence of fecal matter in surfaces, particularly in the toilet, makes it possible for other people to get infected easily. Though a range of cleansing agents is successful in the elimination of vegetative types of CDI pathogens, just chlorine-associated decontaminators and volatilized hydrogen peroxide are effective against spores.

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Since there are inadequate studies on numerous classy, proprietary, commercially obtainable combination agents with sporicidal benefits (that is, products having chlorine in addition to surface-active agents), cautious deliberation ought to be ascertained while choosing cleansing agents for use in health facilities, if the objective is to control and prevent Clostridium difficile infection. Disinfection using a suitably diluted concentration of sodium hypochlorite has been proved successful in eliminating pathogens in patient surroundings and decreasing the level of CDI infection in health institutions. In their research about CDI infection and prevention, Surawicz et al. (2013) found that a considerable decrease in the level of infection may be linked to the application of a hypochlorite-anchored antiseptic, instead of the utilization of detergent-founded solutions.

Theoretical Framework

The germ theory of disease affirms that microorganisms cause the occurrence of some infections. Microorganisms are very tiny organisms that can only be observed through magnification. They invade the bodies of people and other living things where they cause diseases attributable to their reproduction and increase within the host. In line with the theory, germ denotes not just a bacterium but every form of microorganism, particularly the ones that cause diseases, for example, virus and fungus (Fry, 2013). In the course of the past two decades of the 19th-century, the germ theory of disease transformed both the health care notions and the art of surgical procedure though the medications, antibiotics, and vaccines that enhanced treatment and prevention of the numerous epidemics were not existent and were later developed in the 20th-century.

The disease-causing microorganisms are referred to as pathogens while the illnesses they cause are known as infectious diseases. The rationale for picking this theory lies in its affirmation that even when pathogens are the major causes of illnesses, environmental and hereditary aspects usually influence the severity of the ailment, and the likelihood of a given host suffering infection attributable to the exposure to microorganisms. The theory ascertains that particular pathogens result in given illnesses; microorganisms increase within the host and are transmitted from the infected individual to others. Health professionals could employ the significance of the theory to enlighten people on the best approach to cleaning their homes and ensuring modern hygienic practices (Ellingson et al., 2014). Germ theory of disease has noteworthy insinuations for the manner in which people prepare their meals, choose their foods, and uphold sanitary practices.


Dubberke, E. R., Carling, P., Carrico, R., Donskey, C. J., Loo, V. G., McDonald, L. C., & Gerding, D. N. (2014). Strategies to prevent Clostridium difficile infections in acute care hospitals: 2014 update. Infection Control & Hospital Epidemiology, 35(2), 48-65.

Ellingson, K., Haas, J. P., Aiello, A. E., Kusek, L., Maragakis, L. L., Olmsted, R. N., & VanAmringe, M. (2014). Strategies to prevent healthcare-associated infections through hand hygiene. Infection Control & Hospital Epidemiology, 35(8), 937-960.

Fry, D. (2013). Surgical infections. London: JP Medical Ltd.

Goldstein, E. J., Johnson, S., Maziade, P. J., McFarland, L. V., Trick, W., Dresser, L., & Low, D. E. (2015). Pathway to prevention of nosocomial Clostridium difficile infection. Clinical Infectious Diseases, 60(2), 148-158.

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Kundrapu, S., Sunkesula, V., Jury, I., Deshpande, A., & Donskey, C. J. (2014). A randomized trial of soap and water hand wash versus alcohol hand rub for removal of Clostridium difficile spores from hands of patients. Infection Control and Hospital Epidemiology, 35(2), 204-206.

Landelle, C., Verachten, M., Legrand, P., Girou, E., Barbut, F., & Buisson, C. B. (2014). Contamination of healthcare workers’ hands with Clostridium difficile spores after caring for patients with C. difficile infection. Infection Control and Hospital Epidemiology, 35(1), 10-15.

Surawicz, C. M., Brandt, L. J., Binion, D. G., Ananthakrishnan, A. N., Curry, S. R., Gilligan, P. H., & Zuckerbraun, B. S. (2013). Guidelines for diagnosis, treatment, and prevention of Clostridium difficile infections. The American Journal of Gastroenterology, 108(4), 478-498.

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