Nicola Sturgeon told MSPs an outbreak of C Difficile in Tayside could be the subject of a public inquiry.

She said the parameters set for a planned probe into the Vale of Leven outbreak were flexible enough to allow Lord MacLean to examine the latest cases.

The Health Secretary was making a statement to MSPs following the outbreak at Ninewells Hospital. The bug killed two patients and contributed to the deaths of three others in one ward, where eight elderly people became ill.

The outbreak was declared on October 19 and the patients died between October 21 and November 6.

However, Ms Sturgeon said an earlier death in September had now been reclassified, meaning the outbreak spanned 10 weeks.

She said: "I am advised by NHS Tayside that they kept patients and their relatives fully informed. Initial action has, rightly, focused on dealing quickly and effectively with the outbreak."

However, Labour health spokeswoman Jackie Bailey hit out at a "lack of transparency" among health chiefs and questioned why NHS Tayside's "trigger" for an outbreak being declared was three cases, while in other health boards it was only two.

The Health Secretary acknowledged the three case guidance, but said individual cases of Clostridium difficile are appropriately managed with a procedure that "would include the isolation or cohort care of patients".

Tory health spokesperson Mary Scanlon asked if staff dress codes or patient's laundry services would be changed to help prevent the spread of infections.

Ms Sturgeon said various pilots schemes would be examined. She also stressed that Health Protection Scotland had visited the hospital on October 29 and found that the ward had sufficient control measures in place.

The new Healthcare Environment Inspectorate visited the hospital on Wednesday and a "deep clean" of the ward also took place.

She told MSPs "I can assure the families of those that have been so tragically affected that any follow-up action needing to be taken will be acted upon swiftly by NHS Tayside, by the Government".

The Government has ordered a public inquiry into a separate six-month C diff outbreak in Vale of Leven Hospital in West Dunbartonshire last year, which killed nine patients and contributed to the deaths of nine others.

However, Ms Sturgeon said that probe could potentially also examine the circumstances of the Tayside outbreak.

She said the remit of the investigation should "not fetter the ability of Lord MacLean and the inquiry to look at whatever examples and whatever cases of C diff they wish to do so".

The inquiry is currently at an evidence gathering stage and a spokesman said it was too early to comment on whether Lord MacLean would choose to include the Tayside outbreak in the probe.

And Ms Sturgeon stressed that the outbreak in Ninewells and the one in Vale of Leven were different.

"At the heart of what went wrong at the Vale of Leven Hospital was an outbreak that went completely unnoticed and unidentified and therefore was allowed to run amok through six wards in that hospital, affecting more than 50 patients and causing or contributing to the deaths of 18. So there is a significant difference there."