Background: In response to Clostridioides (Clostridium) difficile infections (CDI), infection prevention and control practices in hospital settings tend to focus on symptomatic patients, potentially neglecting other sources of C. difficile. The purpose of the study was to identify epidemiological connections between C. difficile positive patients to explore the possibility of transmission occurring. This would allow an assessment of IPAC practices to ensure resources were being optimized and targeted to the most appropriate strategies to prevent transmission. Methods: C. difficile was isolated and characterized from 125 patient stool specimens. Isolates were subjected to toxin profiling and ribotyping. Patient locations in the hospital were mapped and epidemiological connections between patients with the same C. difficile ribotype were assessed. Results: A total of 47 distinct ribotypes were identified, with the most common being ribotype 027/NAP1. Of the 41 cases identified as hospital-associated, only four (9.8%) of the cases could be epidemiologically linked to another patient with known CDI. Conclusions: A small minority of hospital-associated infections were found to have an epidemiological link to another known case of CDI suggesting transmission from known cases is rare. This suggested that current IPAC practices were effective in preventing transmission from symptomatic patients, but other sources of C. difficile are potentially unrecognized.