Guidance document for prevention of Clostridium difficile infection in acute healthcare settings.

SCOPE Clostridium difficile infection (CDI) is the most important infective cause of healthcare-associated diarrhoea in high income countries and one of the most important healthcare-associated pathogens in both Europe and the United States. It is associated with high morbidity and mortality resulting in both societal and financial burden. A significant proportion of this burden is potentially preventable by a combination of targeted infection prevention and control measures and antimicrobial stewardship. The aim of this guidance document is to provide an update on recommendations for prevention of C. difficile infections in acute care settings to provide guidance to those responsible for institutional infection prevention and control programs. METHODS An expert group was set up by the European Study Group for C. difficile (ESGCD), which performed a systematic review of the literature on prevention of CDI in adults hospitalized in acute care settings and derived respective recommendations according to the GRADE approach. Recommendations are stratified for both outbreak and endemic settings providing. QUESTIONS ADDRESSED BY THE GUIDELINE AND RECOMMENDATIONS This guidance document provides thirty-six statements on strategies to prevent C. difficile infection in acute care settings, including eighteen strong recommendations. No recommendation was provided for three questions.