Effect of cohorting strategy and focused care on incidence and mortality of C difficile associated diarrhea: preliminary results from an observational study: Category: Clinical lesson

Abstract

Clostridium Difficile is a common bacteria carried by 8% population. In CDAD (Clostridium Difficile Associated Disease) symptoms arise as a result of disruption of the microflora in the bowel. The primary methods for this include use of antibiotics, and faeco-oral contamination. Both these methods serve to favour proliferation of Clostridium Difficile. Symptoms include diarrhoea, circulatory collapse, pseudomembranous colitis and toxic megacolon, all in turn potentially leading to septicaemia and perforation. A review of CDAD mortality in Midstaffordshire NHS Trust in 2008 identified measures for improvement of the management of CDAD. In January 2009 new antimicrobial guidelines and environmental hygiene changes were introduced. In March 2009 a new treatment protocol for managing CDAD was implememted, including appropriate initiation of antibiotics, attention to nutrition and prompt escalation of treatment and in August 2009 the CDAD cohort ward was completed.