HYBRID EVENT: You can participate in person at Rome, Italy or Virtually from your home or work.

4th Edition of World Congress on Infectious Diseases

June 21-22, 2023 | Rome, Italy

June 21 -22, 2023 | Rome, Italy
Infection 2023

Namiz Damani

Speaker at World Congress on Infectious Diseases 2023 - Namiz Damani
Betsi Cadwaladr University Health Board, United Kingdom
Title : Control of C. difficile-associated disease using a Multimodal Intervention


Clostridioides difficile has been recognized as the most common cause of hospital-acquired diarrhoea. The symptoms vary from mild diarrhoea to fulminating infection, leading to pseudomembranous colitis and death. Since 2003, C. difficile-associated disease (CDAD) has been a part of mandatory surveillance in the UK; mandatory surveillance in Northern Ireland was introduced in 2004. The UK Department of Health has published guidelines on the control of CDAD and has also developed a ‘care bundle’ to reduce the risk of acquiring C. difficile.
Since 2008, The Southern Health & Social Care Trust (SHSCT) noticed a rise in the number of new cases of CDAD. As a result, our trust’s infection prevention control and senior management team developed a comprehensive intervention plan which included early diagnosis, prompt isolation of all patients with diarrhoea in a single room or cohort ward, implementation of contact precautions with a campaign to promote hand hygiene, implementation of an antibiotic stewardship programme, education and training of all clinical staff, enhanced environmental cleaning with compliance monitoring, enhanced surveillance and feedback via an e-dashboard and root cause analysis for all patients.
Implementing a multimodal intervention strategy has proven very effective. We have since noted a reduction in the incidence of C. difficile cases from February 2009 onwards in all the healthcare facilities within the SHSCT, both in hospital and community cases. Following the intervention, the reduction of CDAD fell in patients aged ≥65 years from 164 cases in 2008-09 to 37 cases in 2009-10, a reduction of 77% within one year. However, what was particularly notable was that following the intervention, we started to see a reduction in CDAD after six weeks, and a 65% reduction in cases which continued till 2021/2022 (Fig 1). In conclusion, it is possible to reduce hospital-cquired CDAD via the implementation of a multimodal intervention strategy.


Dr Damani studied medicine at the University of Malta, having graduated in 2019 and is currently working as an internal medicine in the UK. Dr Damani has done presentations at infection prevention and control conferences, both nationally and internationally. Most recently, he has led a quality improvement project involving 3 PDSA cycles on improving compliance with local antibiotic guidelines at a regional level.