CDC Guidelines and Detecting C. Difficile Infection

October 29, 2020
Jonathan Alicea

Jonathan Alicea is an assistant editor for HCPLive. He graduated from Princeton University with a degree with English and minors in Linguistics and Theater. He spends his free time writing plays, playing PlayStation, enjoying the company of his 2 pugs, and navigating a right-handed world as a lefty. You can email him at

The CDC has standardized guidelines to help diagnose diarrhea, a potential indicator of c. difficile infection.

Unnecessarily isolating individuals due to suspected c. difficile infection (CDI) can place a financial burden on the healthcare system as well as cause emotional toil for the patient. Thus, it becomes all the more imperative to determine risk factors for CDI.

In an interview with HCPLive®, Michelle Thomas, MD, of Harlem Hospital Center, discussed the US Centers for Disease Control and Prevention (CDC) guidelines and definitions for diagnosing diarrhea—a symptom of CDI—in patients.

As per this strict definition, the patient is considered to experience diarrhea if they have ≥3 loose stools within 24 hours. Thomas stressed the importance of adhering to this guideline.

“From my experience, we would have a patient with 2 loose stools, and the nurse would be like, ‘Doc, I’ve sent off a stool sample for clostridium difficile and whole bunch of work-up — which is not supposed to be the case,” Thomas said.

She especially discouraged this among recently admitted patients who likely have not been on antibiotics for long or who have had little exposure with potential sources of C. diff.

“So, the CDC gave us a strict definition in terms of diarrhea, and I believe we should follow that and treat patients accordingly,” she emphasized.

Thomas also stressed for clinicians and healthcare providers to be mindful of the risk factors that may predispose a patient to C diff. This may include length of hospital stay, amount of diarrhea passed, or ethnic disparities—a consideration which she acknowledged should be examined more closely in future studies.