Contact Precautions Plus are indicated for patients with laboratory-confirmed Clostridium difficile associated diarrhea. Precautions must be maintained for duration of hospitalization. A negative subsequent test result will not justify stopping precautions. For patients hospitalized for greater than 30 days after a positive test, consult the Infection Control Unit staff to determine if precautions may be discontinued.

Patients being admitted/readmitted with a history of C. difficile disease, who have completed a course of appropriate antibiotic therapy and are asymptomatic, need not be put on precautions. Patients who have completed a course of antibiotic therapy for C. difficile disease, but continue to be symptomatic, should be put on precautions upon admission/readmission. Patients being admitted/readmitted on treatment for C. difficile disease should be placed on precautions.
C diff has spores, need BLEACH to clean it (not a phenolic or quaternary ammonium product).

Question:  Do you recommend repeat testing for C diff after the patient has been treated?

Answer:  Certainly not if he/she is improving, as a repeat positive with any of the myriad C diff tests out there is quite common shortly after C diff treatment, and treating improving/resolved C diff with antibiotics is a bad move. So when would you check again? I find repeat C diff testing helpful in someone with a recent episode who’s now having vague symptoms (e.g., not a florid relapse), as a negative result suggests that it’s probably post-infectious GI issues (alteration of normal flora would be the broad generalization of what causes this) rather than a relapse of C diff.

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