Inpatient Care, Quality and Population Health

C. difficile Isolation Recommendations Based on Updated Testing Algorithm

On December 19, 2018, Englewood Hospital changed the testing algorithm for C. difficile to eliminate reflex PCR testing. The goal is to differentiate colonized patients from those with active C. diff infection.

If diarrhea and suspected C. difficile infection, place patient on contact precautions and send stool for C. difficile testing as soon as possible. Note the following:

  • Patient should have diarrhea (greater than or equal 3 unformed or liquid stools in <24 hours) to be tested for C. difficile
  • Stool specimen must conform to the shape of the container for the lab to run the test.
  • Testing is not recommended for patients without evidence of an infectious process and who have other clear identifiable causes of diarrhea such as recent oral contrast, laxatives, or tube feeds.
  • The C. diff test is for antigen and toxin. PCR testing may be ordered with GI or ID approval, only if a high clinical suspicion for C. Diff remains after a toxin negative test.
  • C. difficile is considered a hospital acquired infection if the patient tests positive >3 days from the time of hospital admission.
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