Clostridioides (Clostridium) difficile infection

What to know

Clostridioides difficile infection (CDI) is a gastrointestinal disease with a clinical spectrum ranging from asymptomatic colonisation, mild and self-limiting disease, to a severe life-threatening pseudomembranous colitis, toxic megacolon, sepsis syndrome and death. Clostridioides difficile infection usually occurs in the context of risk factors, such as repeated hospitalisation, extensive antibiotic use, older age, or multiple co-morbidities.

Clostridioides difficile infection is easily spread via the faecal–oral route or via direct and indirect contact by hands, devices, fomites, or the environment. Robust Infection prevention and control practices should be in place to limit spread.

The Clostridioides (Clostridium) difficile infection prevention and control guideline (PDF 360 kB) is available to support local hospital and health services in safely managing cases of Clostridioides difficile infection.

Information for consumers

The following guide provides patients with information regarding Clostridioides difficile infection.

About this guideline

The Clostridioides difficile infection prevention and control guideline (PDF 360 kB) provides evidence-based recommendations for managing Clostridioides difficile infection and preventing its transmission in healthcare settings.

Clinician quick reference

This summary provides all clinician, including those from specialties other than infection prevention and control and infectious diseases, with support on the immediate infection prevention and control practices required when there is a suspected or confirmed case of Clostridioides difficile.

Table 1: Clinician quick reference guide for Clostridioides difficile

Key points
  • Suspect Clostridioides difficile infection in a patient who has clinical features suggestive of Clostridioides difficile (diarrhoea, ileus, toxic megacolon).
  • Clostridioides difficile may spread person-to-person spread through the faecal-oral route or by direct or indirect contact.
  • Refer to Outbreak management in healthcare facilities in the event or an outbreak of Clostridioides difficile.
Instructions for patient care
Notify Infection prevention and control professional and patient flow units that Clostridioides difficile is under investigation.
Adhere to SIGHT protocol for any suspected case
S Suspect Clostridioides difficile infection for any adult patient who develops diarrhoea with no clear cause, particularly in those who have been prescribed antibiotic or immunosuppressive therapy in the last 12 weeks.
I Isolate the patient in a single room with unshared ensuite.
G Wear gloves and apron/gown for all patient contact as per contact precautions.
H Hand hygiene with alcohol-based hand rub following glove removal, or soap and water if hands are visibly soiled or when there is a breach in glove integrity. Adhere to bare below the elbows.
T Test the stool for Clostridium difficile toxin.
Patient management pending results Isolate in a single room with unshared ensuite and use contact precautions until diarrhoea has ceased for 48 hours.
Cohort with Clostridioides difficile infection patients based on microbiological confirmation of the cause of diarrhoea.
Personal protective equipment (PPE) All staff wear gloves and apron/gown as per contact precautions.
Patient transfer Notify Queensland Ambulance Service, the receiving facility or unit of the patients confirmed Clostridioides difficile status when transferring a patient.
Visitors Visitors do not need to wear gown and gloves but must perform hand hygiene. Where there is prolonged contact or likely contact with faeces, gloves as a minimum are recommended in conjunction with strict adherence to hand hygiene.
Patient equipment Dedicated patient equipment or clean and disinfect equipment and environment between each patient use or encounter. Single-use bed pans can be utilised where possible. Patient dedicated re-useable bed pans should be reprocessed in the ward washer/disinfector between uses by themselves and cannot be washed with items from other patients.
Cleaning Use ARTG-listed combined detergent and disinfectant products (2-in-1 clean), or ARTG-listed chemical disinfectant with claims for use against C. difficile (as part of 2-step clean). Enhanced environmental cleaning and disinfection (daily and on discharge from any clinical zone).
Alerts Alerts will be placed in the ieMR and HBCIS.
Waste and linen Follow existing current waste and linen management policies as for any other multi-resistant organism. Place linen into skip at point of use, do not carry against the uniform.

Implementation

The SIGHT protocol poster has been developed to assist with implementing the guideline locally.

Evidence statement

The content on this page is informed by the Clostridioides difficile infection prevention and control guideline (PDF 360 kB). This content is not directly referenced for ease of reading. References can be found in the guideline.

Related links

Queensland Health resources

National resources

Last updated: 18 June 2026