How hand washing can prevent C. diff

A recent update to the recommendations for preventing health care-acquired infections (HAIs) has put a spotlight on ways that health care workers, patients and hospital visitors can help stop the spread of the very dangerous Clostridium difficile (C. diff) infection.

C. diff is a germ that can cause symptoms ranging from diarrhea to life-threatening inflammation of the colon. According to a recent study, C. diff infections nearly doubled between 2001 and 2010, and are now the most common bacteria to cause HAIs.

Illness from C. diff most commonly affects older adults in hospitals or in long-term care facilities and typically occurs after use of antibiotic medications. However, research shows increasing rates of infection among people traditionally not considered high risk, such as younger and healthy individuals without a history of antibiotic use or exposure to health care facilities.

The Centers for Disease Control and Prevention (CDC) says that 14,000 Americans die every year from C. diff infections and 337,000 people are hospitalized.

“C. diff continues to be a significant threat to the health, and sometimes lives, of hospitalized patients,” says Dr. Kamo Sidhwa, an infectious disease specialist on staff at Advocate South Suburban Hospital in Hazel Crest, Ill.  “And, without undertaking proper prevention measures, C. diff could continue to grow into a major public health issue.

C. diff is shed in feces, and Dr. Sidhwa says that the diarrhea is what allows the bug to spread so fast, particularly in hospitals and the home.

“The majority of patients who become infected do so because of oral-fecal contamination, meaning traces of one person’s feces enter another person’s digestive system through the mouth,” she says. “The C. diff spores are transferred to people primarily by the hands of others who have touched a contaminated surface or item.

The newly updated C. diff prevention guidelines for hospitals and other health care facilities include stressing appropriate antibiotic use, patient isolation, proper cleaning protocols and an alert system for identifying affected patients.

Patients and families can help control infection, as well. Dr. Sidhwa says that the number one thing that a person can do to prevent transmission of C. diff is to wash their hands, particularly after using the toilet or being around someone who is ill.

“Studies show that properly washing hands with soap and water can eliminate 98 percent of bacteria and spores such as those that cause C. diff,” Dr. Sidhwa says. “We really stress using soap and water, as alcohol-based gels kill bacteria, but not the spores.”

Dr. Sidhwa recommends the following CDC guidelines for hand hygiene:

• Wet your hands with clean, running water (warm or cold), turn off the tap, and apply soap.
• Lather your hands by rubbing them together with the soap. Be sure to lather the backs of your hands, between your fingers, and under your nails.
• Scrub your hands for at least 20 seconds. Need a timer? Hum the “Happy Birthday” song from beginning to end twice.
• Rinse your hands well under clean, running water.
• Dry your hands using a clean towel or air dry them.

She also says that you should insist that other people, particularly physicians, nurses and staff in a hospital setting, wash their hands.

“Don’t be shy about taking control of your health, or the health of someone you love,” she says. “People are busy, and sometimes they may forget. But you can really have a positive affect by politely and assertively asking them to wash up.”