Clostridium difficile-associated disease: how much do we really know? A single institution study

Introduction

Clostridium difficile (C. difficile) is the most common cause of antibiotic-related diarrhoea. In the immunocompromised host it is a source of considerable morbidity. Transmission between patients is preventable. The aim of this study was to survey healthcare professionals’ knowledge of Clostridium difficile infection (CDI) at our institution.

Methods

A written survey was distributed to doctors and nurses of a major tertiary institution. The survey polled knowledge and management decisions regarding clinical scenarios relating to C. Difficile-associated disease and transmission. Survey responses were collated and analysed.

Results

One hundred and forty-six healthcare professionals (91.3%) completed the survey (81 nurses, 65 doctors). Thirty-two (21.9%) had attended an educational seminar on C. difficile. No healthcare worker was able to correctly answer all survey questions. Only four (2.7%) respondents correctly identified all major risk factors for CDI. Respondents who had previously attended a CDI information session were more likely to identify broad-spectrum antibiotic use as a risk factor (97% v. 82%, P = 0.046), and more likely to be aware of the existence of CDI in the community setting (97% v. 78%, P = 0.02). Thirty-four (23.3%) respondents identified the most important management aspects in non-severe CDI, while 85 (58.2%) identified the best method to remove C. difficile spores. Doctors were less likely to identify the correct method of preventing the transmission of the spore-form of C. difficile than nurses (49% v. 69%, P = 0.04). Overall survey performance was better among employees who had attended an information session regarding CDI, (63.1% v. 56.7%, P < 0.01).

Conclusions

Knowledge of CDI is poor among healthcare professionals. A potential for further education exists.