Useful Information Information for patients Diagnosed with Clostridium Difficile INFECTION CONTROL © NHS Direct - 24 hour advice and health information service NHS Direct Tel No: Local Pharmacy - Your local pharmacies offer a wide range of services including information and general advice on symptom relief medicines as well as a prescription collection and delivery service. For more information contact a member of the infection control team Phil Broad, AnnMarie Tully, Christine Howell and Sarah Gray on /11

4 Caring for people with Clostridium difficile 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 and dries with kitchen roll. 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. If it does not improve over the week contact your GP 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. Thoroughly clean bathroom with a bleach solution using a disposable cloth Wipe areas around the house with a bleach type detergent especially door handles, chair arms, etc Clean any carpet spills with disposable cloths and 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 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 as the bacteria can remain in your gut for a number of months without causing you any problems. When is the Clostridium difficile is no longer infectious? Can Clostridium difficile come back? YES! Some patients may suffer a relapse of Clostridium difficile 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.

63 Caring for people with Clostridium difficile 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. 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. Waste Dispose of any incontinence pads etc into household waste (double bagged.) General information Laundry Wash bed linen and towels at 60˚C Tumble dry if possible and iron. Personal clothing -wash at the highest temperature the fabric allows Do not wash with other household laundry. Diet Ensure you drink plenty of fluids, avoid fruit juices. Eat a light diet Drinking probiotic drinks may help Equipment All equipment should be cleaned with a bleach solution prior to returning to the Community Equipment Store Do not share any loaned equipment Social activities Stay at home whilst suffering from diarrhoea. Once you have been free from diarrhoea for 48hours you can return to normal social activities Antibiotics Take your treatment as prescribed by your GP, usually an antibiotic called Metronidazole for 10 days

27 What is Clostridium difficile? It is a bacterium (bug) that can cause infection in the gut. It is found in the gut of a small number of healthy adults and children where it may not cause any problems. This infection mainly occurs after taking certain antibiotics which alters the gut flora and allows clostridium difficile bacteria to grow in number. The Clostridium difficile can produce toxins which lead to diarrhoea and swelling of the bowel. The bacteria can form a barrier around it called a spore, and can survive in the environment for a long time. You can get Clostridium difficile by ingesting (swallowing) the bacteria, ‘usually hand to mouth’. Clostridium difficile is passed on when bacteria is expelled during diarrhoea. Furniture and equipment can become covered in these spores and people can become infected by touching furniture, then touching their mouth. The bacteria can also be transferred from the hands of other people which can transfer the infection on. How did I get Clostridium difficile? If the diarrhoea is not settling following completion of your antibiotics, then you need to contact your GP. You may need another course of treatment or a different antibiotic. DO NOT take any anti-diarrhoea medication. The antibiotics you have been prescribed should help stop your diarrhoea. Visitors Visitors should wash their hands with liquid soap and dry with disposable paper towels when leaving your home. General information continued