Preventing Clostridium difficile transmission and infection continues to represent a serious and difficult challenge in infection prevention and patient safety. In this module, you will learn about how C.difficile is spread, and best practices for preventing the spread of the germ in your facility. The learning objectives for this module are to describe the epidemiology of C.difficile. Describe how C.difficile is spread. Describe the control measures for C.difficile. Clostridium difficile is a rod shaped, spore forming bacteria that is normally found in the intestines. It causes disease by producing toxins, and is transmitted by the fecal-oral route, meaning it has to be ingested. C.difficile infection is one of the most common health care acquired infections that frequently causes life threatening diarrhea in elderly persons residing in nursing homes. In 2000, a stronger strain of the bacteria emerged, which is more virulent than previous strains. CDC estimates that there are 250,000 infections and 14,000 deaths per year. Infections and deaths due to C.difficile have increased dramatically between 2000 and 2007, with approximately half of the infections, and more than 90% of deaths occurring in people aged 65 and older. Patients in the hospital with C.difficile infection are more likely to be discharged to a long-term care facility. Recent data shows that 41.5% of patients hospitalized with C.difficile are discharged to long-term care facilities. As a result, a significant number of individuals may be carrying C.difficile on admission to a long-term care facility, and up to 20% may acquire the organism during their stay. As a consequence of the high numbers of residents already admitted to long-term care facilities with C.difficile from the hospital, and the subsequent colonization of other residents, the prevalence of C.difficile colonization in nursing home has been reported to be as high as 46%. >> Previously on Gowns and Gloves, has David's Hollywood romance with Minerva inadvertently created complications for his grandmother, Mrs. Houston? How will his love story end? And more importantly, will Mrs. Houston receive her own kind of storybook ending? Find out next on Gowns and Gloves. >> Hello, Mrs. Houston. It's your lucky day. It's the last day of your antibiotic treatment. >> How can I be happy when I'm in so much pain? My stomach is in pieces. I have the big D. >> You mean diarrhea? >> Yes, a lot and often. >> I'm so sorry, that sounds very uncomfortable. >> Yes, I just feel drained. >> Good morning, darling. [SOUND] How are you feeling today? Today is the last day of your antibiotic treatment. >> Unfortunately, Mrs. Houston is not feeling well today. She's had to make frequent trips to the bathroom yesterday and today for a bout of diarrhea. >> The big D. >> What is going on with Elaine? >> I think, you may have another infection, Mrs. Houston. Sometimes, people taking antibiotics can be affected by a bad bug called Clostridium difficile. Given the symptoms you told me about, I have a feeling this may be the case. I'll call Dr. Kennedy. You keep drinking your fluids. >> Cut. >> That is great stuff, you are all really learning. Clostridium difficile, or C.diff, is the most frequent cause of antibiotic associated diarrhea in nursing homes. >> Yeah, but is there anything my character could have done to prevent this? >> Unfortunately, C.diff is a side-effect of receiving antibiotics. It is more common in persons over the age of 65, and among long-term residents in nursing homes and other healthcare facilities. Now, the best way for residents to reduce their chances of getting C.diff is to wash hands frequently with soap and water, especially after using the bathroom, before eating, and before and after group activities. And you should also remind your nurse and others entering your room, to wash their hands before and after having contact with you, all right? Back to, action. >> Oh. I am sorry you are feeling badly. >> Thank you. [MUSIC] I'm just disappointed, because today, we were going to tell Priscilla our secret. >> What secret? >> Recipe, secret recipe. You know the brownies that you and Elaine were talking about. You both have secret family recipes, and Elaine was going to share her's with you. >> That's right. >> Oh, how sweet. I'll have to show you mine, so we can compare. It was my mother's recipe. When I was little, I never liked birthday cakes, so she used to make me birthday brownies. She said it was a secret family recipe. That's all I ever knew about my mom's family. Secret family recipe for birthday brownies. At least it's a happy memory. My mom died when I was nine. >> I know. I mean, great memory to have though. >> True, and the brownies really are fantastic. But we've got more important things at hand. We need to help you get this diarrhea cleared up. >> You mean the Big D. >> Yes, the Big D. I need to make sure that you are clean and comfortable. And I'd like to get a stool sample. Mr. Houston, I mean, Dimitri. Would you excuse us? >> Yeah, of course. [MUSIC]