What is Clostridium difficile 
Clostridium difficile infection is the most important cause of health care associated diarrhoea. C.difficile is a bacteria that is present in the gut of up to 3% of the healthy adults and 66% of infants. However C.difficile rarely causes problems in children or adults, as it is balanced by normal gut bacteria.

Certain antibiotics disturb the balance of the bacteria in the gut causing the C.difficile to rapidly multiply and produce toxins which cause illness.

C.difficile infection ranges from mild to severe diarrhoea to, more severe inflammation of the bowel.

C.difficile infection is usually spread on the hands of health care staff and other people who come into contact with the infected patients or the environmental surfaces contaminated with the bacteria or spores. The spores are very hardy and can survive on clothes and environmental surfaces for long periods.

1. Patient information leaflet
2. www.hpa.org.uk

What are we doing to protect you?
Patients presenting with symptoms of diarrhoea should be isolated in a single room, a stool specimen tested for an infective cause, infection control measures are put into place, namely, all staff and visitors will be advised to wear aprons and gloves before entering the single room, to wash their hands with water and soap after removing the apron and gloves and immediately before coming out of the single room. Isolation sign

The single room will be  cleaned twice a day with detergent and bleach.  The patient’s condition is monitored and reviewed daily by the ward team and the Infection Prevention and Control Nurse.

National Targets
Between April 2007 and March 2008, PHNT had the lowest rate of C.difficile for patients over 65 years of any teaching hospital in England. The new national target requires PHNT to reduce the post 72hour cases of C. difficile by 10% by March 2011. The baseline figure for 2007-08 was 170 cases and the Trust reported 164 cases this year.  Between April 2008 and March 2009 the Trust reported 139 cases.

2. C.difficile monthly chart
3. C.difficile annual chart

The Trust will require further reductions over the next two years to remain on programme to achieve the national targets. The Trust is working towards their C.difficile reduction action plan through a series of measures.  All confirmed positive C.difficile patients and patients previously known to be C.difficile positive on readmission are clinically assessed daily by an Infection Control Nurse and the management of each patient discussed at the daily operational C.difficile meeting

The control measures implemented are monitored throughout the patients hospital stay. Each positive case is investigated using the Department of Health root cause analysis tool any issues identified are actioned and reported to the Quality and Safety Infection Prevention Board Chaired by the Chief Executive everymonth.