Clostridium difficile Infection: Patient Information, Exams of Public Health

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3 Boroughs Public Health Infection

Prevention and Control Team

Information for

patients

diagnosed with

Clostridium difficile

Infection

What is Clostridium difficile?

Page

When is the Clostridium difficile no

longer infectious?

Caring for people with Clostridium

difficile Infection

General information

How did I get Clostridium difficile?

Treatment

Can Clostridium difficile Infection

come back?

Once the diarrhoea has stopped

Useful information

Own home

Client should stay at home until they have been clear of diarrhoea for 48 hours.

GP practice

Avoid going to the GP surgery when suffering from diarrhoea. If you need to attend, inform the GP you have the infection prior to attending the surgery.

Crockery and cutlery

Wash in hand hot, soapy water. No additional precautions are required.

Cleaning

Clean toilet and bathroom with a bleach solution (ratio 1 part bleach to 10 parts water) or detergent containing bleach, e.g. Flash with bleach.

Use disposable cloths.

Wipe other areas with a detergent e.g. washing up liquid using a disposable cloth. Clean commodes as you would a toilet.

If your stool specimen is positive for Clostridium difficile toxins you will be started on treatment either – metronidazole OR Vancomycin. ENSURE THAT THE COURSE OF ANTIBIOTICS IS COMPLETED.

Caring for people with Clostridium

difficile Infection

Treatment

Waste

Dispose of any incontinence pads etc into household waste (double bagged).

Hand washing

• After going to the toilet.
• Thoroughly wash your hands with liquid soap and running water.
• Dry hands with own towel or kitchen roll. (If you require assistance taking you to the toilet, ensure your carer also washes their hands with soap and water and dries with kitchen roll and disposes of it into a bin.)
• After cleaning the environment.
• Before and after meals.

Use soap and water for hand washing - alcohol based hand gel is NOT effective against this infection.

Bowel movements

Keep a record of how often you have diarrhoea to observe for any improvement in your condition. Use the Bristol Stool Chart (see additional information). If it does not improve over the week contact your GP or the Infection Control Specialist Nurses on 01925 867707 for advice.

If you have any fever, acute pain or abdominal distension out of Surgery hours, report this to the out of hours GP service.

Caring for people with Clostridium

difficile Infection

Once the diarrhoea has stopped

When is the Clostridium difficile no

longer infectious?

Can Clostridium difficile Infection

come back?

• Thoroughly clean bathroom with a bleach solution using a disposable cloth starting from the top and work your way down.
• Wipe areas around the house with a bleach type detergent e.g. Flash, especially door handles, chair arms, etc.
• Clean any carpet spills with disposable cloths and neutral detergent.
• Dispose of used cloths in a plastic bag.
• All equipment that has come into contact with you, i.e. medical equipment should be cleaned and disinfected.
• Wash your bedding on the hottest temperature the fabric will allow.

Once the diarrhoea has stopped for at least 48 hours and your bowel motion is back to normal you are not considered to be infectious.

There is no need for you to do another stool specimen for clearance.

YES! some patients may suffer a relapse of diarrhoea.

Bacteria may remain in your bowel for some time afterwards and the diarrhoea may return requiring further treatment, consisting of a further course of antibiotics.

Please contact your GP if you develop diarrhoea again following treatment and inform them that you have had clostridium difficile recently.

If the diarrhoea is not settling following 4 - 5 days on antibiotics, then you need to contact your GP or Infection Control Nurse. You may need another course of treatment or a different antibiotic.

DO NOT take any anti-diarrhoea

medication e.g. lmodium.

Infection Control Nurses

Specialist nurses will contact you and give you a ‘green card’ which you should show any other healthcare professional e.g. Doctor, dentist or pharmacist, if they want you to take any antibiotics in the future.

Visitors

Visitors should wash their hands with soap and water when leaving your home.

General information

Useful Information

Breakfast cereals • Rice krispies, • Wholegrain cereals - cornflakes, Coco Pops Branflakes, Weetabix, Muesli, & Sugar Puffs Shredded Wheat & porridge

Bread, flour, pasta • White bread, rolls and • Brown, wholemeal and & rice pittas granary bread, rolls, pitta

• Chapattis & naan bread • Chapattis & naan bread -
  • made with white flour made with brown or
• White rice wholemeal flour
• White pasta • Rye bread
• Cornflour, sago, tapioca • Brown rice & semolina • Wholemeal pasta
• Couscous, polenta, • Bread with added seeds, fruit tortillas & tacos or nuts
• Currant/fruit loaves

Biscuits, cakes, • Biscuits & cakes made • Biscuits made with brown or crackers, sweets & with white flour - Rich wholemeal flour- digestives, chocolate tea, Morning coffee, flapjacks, oatcakes shortbread & sponge • Wholemeal crackers cake • Cereal bars

• Plain scones
• Crumpets
• Cream crackers
• White crisp bread
• Chocolate & sweets - without added fruit, nuts, seeds & cereals

Dairy products & • Milk and milk products - • Cheese or yoghurt with added fats cream, creme fraiche nuts, fruit or cereals

• Butter, margarine & oil
• Mayonnaise & salad cream
• Smooth yoghurt
• Cheese

Foods low in fibre Foods high in fibre (Avoid)

Useful InformationUseful Information

Fruit • Tinned, stewed or fresh • All fruit with skins, seeds, pith fruit without skins or pulp & pips - raspberries, oranges -peeled apples, pears or & grapes peaches • Dried fruit

• Fruit juice without pulp • Green bananas
  • Fruit juice with pulp

Vegetables • Well-cooked vegetables • Raw vegetables, salads,

• Potatoes without skins sweetcorn, peas, mushrooms
• Vegetable juice without & beans pulp • Vegetable juice with pulp

Drinks • Tea & coffee • Fruit smoothies

• Hot chocolate, Ovaltine • Fruit juices with pulp & Horlicks
• Flavoured water & squash, Milkshakes

Miscellaneous • Seedless, rindless or jelly • Twiglets & savoury snacks varieties of jam & containing nuts e.g. Bombay marmalade mix

• Bovril, Marmite & • Chutneys & pickles chocolate spread • Crunchy peanut butter
• Sugar, honey & syrup • Jams & marmalade with
• Ketchup, bottled sauces seeds or rind & vinegar
• Crisps

Foods low in fibre Foods high in fibre (Avoid)