Hygiene More Effective Than Isolation in Stopping the Spread of C. Difficile

Small changes in daily hygiene are more effective than visitor contact precautions in preventing C. difficile (C. diff.) among elderly patients in long-term care centers, according to a new study published in JAMA Network Open.

Researchers at the University of Wisconsin in Madison, Wisconsin, studied infection control regimens to deter C. diff transmission in a 200-bed acute care adult hospital. Visitor contract precautions (VCPs) are a common regimen, in which visitors don gowns and gloves when entering the room of a patient with a C. diff infection (CDI).

Implementing VCPs requires considerable worker and personal protective equipment (PPE) resources. In addition, VCPs are often associated with adverse effects for patients, as they limit the amount of visitors patients may see and often lead to increased delirium and depression. After researchers accounted for factors such as patient susceptibility, behavior, and transmission, they found VCPs resulted in minimal change, contributing to a 1% or less decrease in infection rate. 

Investigators seeking a better method of containing CDI looked at the effects of stressing health care worker hand hygiene, daily cleaning of patient rooms and common areas, as well as thorough terminal cleaning of rooms between patients. They determined that slightly increasing worker hand hygiene and environmental cleaning compliance— by no more than 2%— were associated with larger infection decreases.