Asymptomatic carriers rarely develop C. difficile-associated diarrhea, but they serve as an important reservoir of nosocomial infection. We need to take into account that the infective dose of toxigenic C. difficile may be as low as 2 organisms. And in infected patients, up to 109 organisms per gram of diarrhoea are excreted. The highly resistant spores lands on surfaces such as bed, linen, medical devices, stetoscopes, etc… and can persist for many months in the hospital environment and can result in infection if ingested by a susceptible host.
It has been proved that washing hands with soap can kill the spores better than alcohol solution, therefore it is very important washing hands on top of the additional measures of prevention (isolate infected patient in a single room with contact precaution measurement) .
