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Infection control nurses told to test twice for C diff

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Two tests must be carried out to diagnose cases of Clostridium difficile in hospital patients, according to latest guidance from the Department of Health.  

The DH said new research had shown that the “most effective testing regime is to use a two test system which improves the specificity and accuracy of testing”.

It estimates that using two tests instead of the current one would lead to a 17% reduction in recorded cases of the healthcare acquired infection in English hospitals. The requirement comes into effect from April.

The guidance states that C. difficile toxin enzyme immunoassays (EIA) are “not suitable as stand alone tests” for the diagnosis or detection of the infection.  Instead a combination of two tests must be used, the first of which should be a toxin gene (NAAT) or glutamate dehydrogenase EIA, followed by a sensitive toxin EIA test.

The guidance added that patients should be tested for C difficile if they had diarrhoea “not clearly attributable” to an underlying condition or therapy.

Infection Prevention Society president Tracey Cooper said the guidance was a “welcome step forward” in achieving accurate diagnosis but prevention was “still the most important measure”.

She added: “This new guidance also reinforces the importance of rapid action by nurses when diarrhoea occurs, to send samples to the laboratory and to isolate patients as they may be infectious.”

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  • another evidence based practice emerge for accountability.

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