title: Clostridium difficile: improving the prevention paradigm in healthcare settings.
abstract: Clostridium difficile infection (CDI) is a major public health problem worldwide with significant morbidity and mortality that is spread by spores and fecal oral transmission. A variety of risk factors have been identified. Some risk factors such as age, are not amenable to change, while others such as antimicrobial utilization have resulted in broadly implemented antimicrobial stewardship programs. New risk factors are emerging such as proton pump inhibitor (PPI) use, irritable bowel disease (IBD) and obesity, with others yet to be determined. Prevention of spread of CDI is imperative, since therapy remains imperfect. We review established and emerging risks for CDI and offer potential preventative strategies with the use of a multidisciplinary CDI prevention bundle checklist.
authors.affiliation: Department of Infection Prevention, Providence Saint John's Health Center, 2121 Santa Monica Blvd, Santa Monica, CA 90404, USA.
authors.forename: Angela
authors.initials: A
authors.lastname: Vassallo
authors.forename: Mai-Chi N
authors.initials: MC
authors.lastname: Tran
authors.forename: Ellie J C
authors.initials: EJ
authors.lastname: Goldstein
mesh_terms: D000367:Age Factors; D016360:Clostridioides difficile / Q000254:growth & development / Q000472:pathogenicity; D003428:Cross Infection / Q000382:microbiology / Q000517:prevention & control*; D004761:Enterocolitis, Pseudomembranous / Q000150:complications / Q000382:microbiology / Q000517:prevention & control* / Q000635:transmission; D005243:Feces / Q000382:microbiology; D006801:Humans; D017053:Infection Control / Q000379:methods*; D064307:Microbiota; D012307:Risk Factors
keywords: C. difficile bundle; Clostridium difficile; Clostridium difficile infection; UV light; antibiotic resistance; antibiotic stewardship; contact isolation; contact precautions; disinfection; fecal microbiome; hand hygiene; hydrogen peroxide vapor infection prevention; probiotics