What infection control measures should be implemented in the practice when managing a patient with C. difficile infection?

When managing a patient with Clostridioides difficile infection (CDI) in general practice, the following infection control measures should be implemented:

• Hand hygiene: Use liquid soap and warm running water for handwashing, as alcohol-based hand rubs do not kill C. difficile spores. Hands should be washed thoroughly after contact with the patient or their environment to remove spores and prevent transmission NICE CKS,NICE CKS,NICE CG139.
• Personal protective equipment (PPE): Wear disposable gloves and an apron when in contact with the patient or their bodily fluids. Remove gloves first, then apron, and dispose of them appropriately. Perform hand hygiene immediately after removing PPE NICE CKS,NICE CG139.
• Environmental cleaning: Decontaminate the immediate environment of the patient using a 1000 ppm chlorine-based disinfectant solution or a combined detergent and chlorine-based disinfectant, especially if the patient has been in the practice within 48 hours of having diarrhoea NICE CKS.
• Patient advice: Advise symptomatic patients to wash hands thoroughly after toileting and before eating, use separate towels washed daily, close the toilet lid before flushing, and clean hard surfaces in toilets and bathrooms daily with household bleach NICE CKS.
• Laundry: Wash soiled clothing and bedding separately from other laundry at the highest temperature the fabric can tolerate NICE CKS.
• Isolation and outbreak awareness: Be aware of the potential for outbreaks, especially in vulnerable populations, and consider isolation or cohorting if multiple cases occur NICE CKS.
• Safety netting: Provide patients with advice on when to seek reassessment if symptoms worsen, as daily clinical review is usually not required in the community NICE CKS.