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Clostridium Difficile

Volume 456: debated on Tuesday 6 February 2007

To ask the Secretary of State for Health what guidance her Department has issued to hospitals on dealing with clostridium difficile; and if she will make a statement. (110517)

The Department has issued the following guidance specifically for the management and control of Clostridium difficile:

a professional letter on health care associated infections including particularly infection caused by Clostridium difficile was issued to all chief executives of national health service acute trusts, primary care trusts and strategic health authorities on 7 December 2006. This letter set out the policies and clinical practices needed to control Clostridium difficile and also included very simple operational guidance for managers;

a high impact intervention on Clostridium difficile was added to our delivery programme ‘Saving lives: a delivery programme to reduce healthcare associated infections including MRSA’ in June 2006. This tool will help to reduce infections; and

a joint professional letter from the chief medical officer and the chief nursing officer went out to national health service trusts in December 2005 reminding them of the importance of this infection and listed the key actions to control Clostridium difficle and highlighted the guidance available1, 2. Copies of the letter have been placed in the Library and it is also available on the Department’s website at:

In addition, we have asked the Health Protection Agency to review the extant guidance issued in 1994. This revised national guidance should be ready in the spring.

All those providing health care services need high standards of hygiene to prevent infections. Specific measures to control Clostridium difficile are restriction, where possible, of broad spectrum antibiotics, isolation of patients and enhanced environmental cleaning, all of these measures are most relevant to those providing in patient services.

Copies of ‘A simple guide to Clostridium difficile and the National Clostridium difficile Standards group: Report to the Department of Health’ have been placed in the Library and are also available on the Department’s website at:


1 Clostridium Difficile Infection, Prevention and Management. A Report by a Department of Health/PHLS joint working group. 1994

2 Guidelines for optimal surveillance of Clostridium difficile infection in hospitals Brazier JS and Duerden BI. Guidelines for optimal surveillance of Clostridium difficile infection in hospitals. Comm.Dis.Pub.Health. 1998:1;(4) 229-230.

To ask the Secretary of State for Health how many cases of Clostridium difficile were recorded in each primary care trust (PCT) area in (a) 2005 and (b) 2006; and how many people died in circumstances in which clostridium difficile was a significant cause of death in each PCT in each year. (110518)

Since January 2004, all acute national health service trusts in England have been obliged to report all cases of Clostridium difficile associated disease in patients aged 65 and over under the mandatory surveillance scheme. These data are not available by primary care trust.

National, regional and individual trust data were published for the years 2004 and 2005 (the latest available data) in mandatory surveillance of healthcare associated infections report 2006 at:

Data for the number of death certificates mentioning Clostridium difficile are not available for 2005 or 2006 yet.