Clostridioides difficile (C. diff)
C. diff precautions
- How long
- Duration of illness (CDC); IDSA/SHEA suggest at least 48 hours after diarrhea resolves
- Room
- Single room, ideally with its own toilet (IDSA/SHEA)
- PPE
- Gown and gloves on room entry
- Hand hygiene
- Soap and water preferred — alcohol does not kill C. diff spores
- Cleaning
- Sporicidal disinfectant, e.g. hypochlorite (bleach) or an EPA List K product
Good to know
- CDC’s Appendix A also says to stop antibiotics when appropriate, not to share electronic thermometers, and to keep environmental cleaning and disinfection consistent; hypochlorite solutions may be needed if transmission continues.
- The 2017 IDSA/SHEA guideline suggests keeping Contact Precautions for at least 48 hours after diarrhea resolves, and longer — up to discharge — if C. diff rates stay high despite standard measures.
What CDC’s table says
Verbatim from CDC’s Appendix A, with bibliography numbers removed.
Gastroenteritis — C. difficile
ContactStandardDurationDuration of illness
Discontinue antibiotics if appropriate. Do not share electronic thermometers; ensure consistent environmental cleaning and disinfection. Hypochlorite solutions may be required for cleaning if transmission continues. Handwashing with soap and water preferred because of the absence of sporicidal activity of alcohol in waterless antiseptic handrubs.
Test yourself: a CIC-style question
Which characteristic of Clostridioides difficile explains its persistence in the healthcare environment and resistance to alcohol-based hand rubs?
- It produces a polysaccharide capsule
- It forms environmentally resistant spores
- It is an obligate aerobe
- It lacks a cell wall
Show answer
B. It forms environmentally resistant spores
C. diff spores survive on surfaces for long periods and are not inactivated by alcohol. That is why soap-and-water hand hygiene and sporicidal agents such as bleach are used.
Questions like this come up in the Preventing and Controlling the Transmission of Infectious Agents domain of the CIC® exam. The 654 questions in the app each come with a written explanation.
FAQ
- What precautions are needed for C. diff?
- Contact + Standard. Room: Single room, ideally with its own toilet (IDSA/SHEA). PPE: Gown and gloves on room entry. Hand hygiene: Soap and water preferred — alcohol does not kill C. diff spores. Cleaning: Sporicidal disinfectant, e.g. hypochlorite (bleach) or an EPA List K product.
- How long do C. diff precautions last?
- Duration of illness (CDC); IDSA/SHEA suggest at least 48 hours after diarrhea resolves.
Sources
- CDC. Appendix A: Type and Duration of Precautions Recommended for Selected Infections and Conditions (2007 Guideline for Isolation Precautions, updated September 2024)
- McDonald LC, et al. Clinical Practice Guidelines for Clostridium difficile Infection in Adults and Children: 2017 Update by IDSA and SHEA. Clin Infect Dis. 2018;66(7):e1–e48
- U.S. EPA. Selected EPA-Registered Disinfectants (Lists G, K, P and others)
Checked against CDC on October 21, 2026. For education and CIC® exam preparation only — not a substitute for your facility’s infection prevention policies, your state or local health department, or clinical judgment. CBIC and CDC do not endorse this tool.