Title

Clostridioides difficile Prevention in the Neonatal Intensive Care Unit (NICU)

Authoring Organization

Society for Healthcare Epidemiology of America

Publication Month/Year

August 29, 2018

Last Updated Month/Year

October 17, 2024

Document Type

Consensus

External Publication Status

Published

Country of Publication

US

Document Objectives

The SHEA intends this document to serve as a companion to the Centers for Disease Control and Prevention (CDC) Healthcare Infection Control Practices Advisory Committee (HICPAC) “Clostridioides difficile in Neonatal Intensive Care Unit Patients: A Systematic Review,” to provide practical, expert opinion-based answers to frequently asked questions on C. difficile detection and prevention in the NICU. These questions are not adequately addressed in the published literature to meet Grading of Recommendations Assessment, Development and Evaluation (GRADE) standards and therefore were not included in the HICPAC systematic review.

Target Patient Population

Neonatal Intensive Care Unit Patients

PICO Questions

  1. When should clinicians test a NICU patient for Clostridioides difficile infection (CDI)?

  2. Before or concurrent with C. difficile testing, which gastrointestinal pathogens should clinicians test for in a NICU patient who develops diarrhea?

  3. What are the best methods for testing for CDI in NICU patients?

  4. What is the preferred hand hygiene agent when caring for NICU patients who test positive for C. difficile?

  5. What is the appropriate type and duration of isolation for an infant with a positive C. difficile test?

  6. What is the appropriate cleaning and disinfection strategy for C. difficile in the NICU?

  7. What is the role for antimicrobial stewardship in the prevention of C. difficile infection in infants?

Inclusion Criteria

Male, Female, Infant

Health Care Settings

Emergency care, Hospital

Intended Users

Epidemiology infection prevention, nurse, nurse practitioner, physician, physician assistant

Scope

Management, Prevention

Diseases/Conditions (MeSH)

D007363 - Intensive Care Units, Neonatal, D015931 - Intensive Care, Neonatal, D016360 - Clostridium difficile

Keywords

infection prevention, C diff, Clostridioides difficile, Cdiff, Clostridioides difficile Infections, NICU, neonatal intensive care unit

Source Citation

Sandora TJ, Bryant KK, Cantey JB, Elward AM, Yokoe DS, Bartlett AH. SHEA neonatal intensive care unit (NICU) white paper series: Practical approaches to Clostridioides difficile prevention. Infect Control Hosp Epidemiol. 2018 Oct;39(10):1149-1153. doi: 10.1017/ice.2018.209. Epub 2018 Aug 30. PMID: 30160646.