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April 28, 1993

Clostridium difficile Colitis: Causes, Cures

Author Affiliations

The Don & Sybil Harrington Cancer Center Amarillo, Tex

JAMA. 1993;269(16):2087-2088. doi:10.1001/jama.1993.03500160053027

To the Editor.  —In their excellent article on C difficile colitis Fekety and Shah1 omit any reference to preventing the nosocomial spread of the organism. McFarland et al2 cultured C difficile from the hands of 59% of the hospital personnel caring for patients with C difficile infections. This group identified C difficile as the cause of 20% of all nosocomial diarrhea cases.3Most attempts to control the transmission of C difficile have been unsuccessful. However, in a prospective, controlled study of the use of vinyl gloves to inhibit nosocomial transmission of C difficile, Johnson et al4 demonstrated a decrease of C difficile diarrhea from 7.7 cases per 1000 patient discharges to 1.5 cases per 1000 during a 6-month period. The use of disposable vinyl gloves should be routine for any person contacting any body substances of patients with C difficile diarrhea.