Infection control audit of Clostridium difficile -associated diarrhoea at the University Hospital of Wales

Abstract

Clostridium difficile is identified as the most common cause of diarrhoea among hospitalised patients, and has been implicated in a number of outbreaks with significant morbidity and mortality. It is widely regarded as a hospital-acquired problem, associated with antibiotic use. An audit aimed at reviewing compliance against local Clostridium difficile-associated diarrhoea (CDAD) policy at the University Hospital of Wales, Cardiff was undertaken from May to July 1999. Despite the difficulty in adhering to national guidelines on single-room isolation, the prevalence of CDAD at our hospital has decreased in recent years. Community acquired CDAD accounted for 15% of our cases, which supports increasing levels of community CDAD (Kalstrom et al 1998). Recent antibiotic treatment was recorded for 82% of the audit cases, with beta-lactam being the most frequently prescribed. Antibiotic treatment for infection other than CDAD was stopped for only 11% of the cases. Where treatment was given for CDAD, clinical staff followed approved guidance.