1. Clostridium difficile transmission.

The two major reservoirs of C. difficile in healthcare settings are infected patients and, since C. difficile can survive in the hospital environment, inanimate objects. C. difficile can be spread by direct and indirect contact with the patient or the patient’s environment.

2. Isolation of patients with CDI.

Guideline recommends to place patient with CD on appropriate contact precautions (CP) and to assign him to a private room with a bathroom that is only for use by that patient (isolation) [1].

Early identification of patients with CDI is the first step in preventing the spread of the disease. For this reason pre-emptive isolation and CP are recommended for all patients with diarrhea, especially if healthcare-associated.

When a private room is not available, the best patient placement options should be determined. A possibility is to place patients with CDI in a cohort where CP must always be applied. In the cohort other actions may be considered, including the use of spatial separation to reduce the possibility of sharing of items.

Isolation of patients with CDI may be discontinued for two days after diarrhea stops. A patient who is cohorted for CDI should be moved to a clean room once diarrhea resolves to prevent re-infection.


  1. Association for Professionals in Infection Control and Epidemiology [Internet]. Washington, DC:  Association for Professionals in Infection Control and Epidemiology; 2013 [cited January 2016]. Guide to Preventing Clostridium difficile Infections. APIC Implementation Guide. Available at http://apic.org/Resource_/EliminationGuideForm/59397fc6-3f90-43d1-9325-e8be75d86888/File/2013CDiffFinal.pdf