Clostridium Difficile Diarrhoea

Introduction

Clostridium difficile diarrhoea can be acquired during a hospital admission, which occasionally, and particularly in the elderly, may result in a serious illness and even death. Two features of this bacterium are of special interest; one is the production of toxins which can damage the cells lining the bowel, and the other is the ability to form spores which enable this bacterium to persist in the environment.

Almost all patients who develop Clostridium difficile diarrhoea are on, or have recently been given antibiotic therapy. Diarrhoea is the most common symptom, but abdominal pain and fever may also occur. In the majority of patients, the illness is mild and full recovery is usual. Elderly patients may become seriously ill with dehydration as a consequence of the diarrhoea. Occasionally, patients may develop a severe form of the disease called “pseudomembranous colitis” (PMC) which is characterised by significant damage to the large bowel. This may lead to a grossly dilated bowel “toxic megacolon” or even perforation. The only treatment for toxic megacolon is a total colectomy.

Purpose

Clostridium difficile is a specific alert organism which is reported on the Public Health England (PHE) Data Capture System. This policy makes for prompt diagnosis, isolation, infection control procedures, environmental decontamination and antibiotic prescribing.

All cases are reviewed by the CCG and if any lapse in care is identified, the Trust is liable for a possible financial penalty if the Department of Health target is breeched.

Definition

Clostridium difficile diarrhoea – diarrhoea not attributable to any other cause, which occurs at the same time as a positive stool.

Policy Details

See also:

• Trust Antibiotic Guidelines
• Infection Control Outbreak / Incident Policy including Major
• Outbreak Policy
• Hand Hygiene Policy for Healthcare Workers
• Standard Precautions Policy
• Isolation Policy
• Cleaning and Disinfection Policy