Increased efforts to prevent the spread of Clostridium difficile, linked to thousands of deaths annually, have failed to reduce infection rates, which have reached historically high levels, according to one recent survey. But another study shows that the person who cleans and disinfects patient rooms and how he does it can make a difference in controlling the deadly bacteria.

In a survey by the Association for Professionals in Infection Control and Epidemiology, 70 percent of respondents said the hospital in which they work has adopted additional interventions to address C. difficile infections. Yet, only 42 percent witnessed a decline in infection rates during that period, while 43 percent did not see a decline, according to APIC's 2013 CDI Pace of Progress survey.

Although cleaning activity has increased, monitoring the results has not kept pace, the survey found. While 92 percent of respondents have increased emphasis on environmental cleaning and equipment decontamination, 64 percent said they rely on observation instead of more accurate monitoring technologies to determine cleaning effectiveness. Fourteen percent said that nothing was being done to monitor room cleaning.

Because C. diff spores can survive in the environment for many months and are highly resistant to cleaning and disinfection, environmental cleaning and disinfection are critical to prevent the transmission of CDI, APIC says.

How that is done makes a difference, notes a study published in the May issue of Infection Control and Hospital Epidemiology, the journal for the Society for Healthcare Epidemiology of America. The study describes the importance of establishing a rigorous cleaning and monitoring regime to control C. diff.

There are 337,000 hospitalizations for C. diff annually in the United States and C. diff is linked to about 14,000 deaths, adding at least $1 billion in health care costs, according to the Centers for Disease Control and Prevention.