About CDI

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What is Clostridium difficile?

Clostridium difficile or C. difficile is a germ that produces a toxin that can cause diarrhea and serious illness of the bowel. It is one of the many types of bacteria that can be found in feces.

What is Clostridium difficile infection (CDI)?

The symptoms of CDI may include mild or severe diarrhea, fever, abdominal cramping, abdominal pain, and dehydration. Generally, CDI does not affect healthy people. However, CDI can be serious in people who are sick, elderly, or have weakened immune systems. In rare cases it can be fatal.

What causes Clostridium difficile infection (CDI)?

The bowel contains many types of bacteria, most of which do not cause illness. CDI occurs when the C. difficile bacteria enters the body through the mouth and grows in the bowel. Those who are at risk may not have enough “good” bacteria in their bowels, allowing the C. difficile bacteria to grow and produce a toxin, which causes diarrhea.

What are the risk factors for CDI?

  • Age 65 years or more
  • Underlying diseases
  • Weakened immune systems
  • Intensive care patients
  • Prolonged hospital stays
  • History of antibiotic usage

How is CDI diagnosed?

A sample of your stool will be requested by your doctor, which will be tested in a laboratory for the presence of C. difficile toxins.

How is CDI treated?

Treatment for CDI is determined on a case-by-case basis, depending on the severity of symptoms. Patients who have mild symptoms may not need any treatment, while those who suffer more severe symptoms may require antibiotics.

How does CDI spread?

Bacteria in the stool of a person who has CDI can contaminate surfaces such as countertops, toilets, door handles and bedpans. CDI can spread when another person touches these surfaces or items with their hands. Infection can occur when that person touches their mouth without washing their hands. Soiled hands can also continue to spread CDI to other surfaces and people.

What happens if I get CDI while I’m a patient in the hospital?

When illness from CDI occurs, precautions are taken to contain the spread of the bacteria. Preventative measures, such as frequent hand washing and cleaning the surrounding area, can help individuals protect themselves from infection and decrease the risk of passing the infection to others.

What can I do to prevent CDI?

Healthy people who are not taking antibiotics have a very low risk of getting CDI. Regular hand hygiene and cleaning of your personal environment can help reduce the risk to you and your family.

Why are hospitals continuing to experience CDI outbreaks?

C. difficile bacteria are found throughout the environment – in soil, water, and food. They also live in small amounts in people’s guts and normally don’t cause illness. We only see illness when the C. difficile grow and produce a toxin – usually because the person carrying the bug is exposed to antibiotics, killing the normal gut flora and allowing C. difficile to grow out of control.

Even if the C. difficile bacteria were eliminated from the hospital environment, it would be continuously reintroduced by new patients coming into the hospital and it can survive for months in a spore form that is very difficult to kill. Even if we wiped down every surface in the hospital everyday with strong chemicals, we would not be able to kill it all.

The focus needs to be on prevention. This includes using antibiotics only when they are needed, and according to your doctor’s instructions; keeping the environment as clean as possible (especially around ill patients) and focusing on hand hygiene.

In order to become infected with C. difficile, a patient needs to swallow the spores. The spores are carried on hands- those of the patient and healthcare providers after touching contaminated surfaces. Everyone needs to take responsibility for ensuring they perform hand hygiene before and after contact with patients, before eating and after using the toilet.

Provincial Surveillance Reports

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Latest Quarterly Report

CDI Quarterly Update: Q2 of 2017-2018

Annual Report

Annual Surveillance Report for the fiscal year 2016-2017

Population under surveillance

The population under CDI surveillance includes inpatients admitted to BC acute care facilities. This includes patients admitted to the emergency department awaiting placement (e.g. patients admitted to a service who are waiting for a bed), patients in alternative level of care beds, and patients in labour and delivery beds.

Outpatient visits to acute healthcare facilities, patients in extended care beds housed in acute healthcare facilities, patients in psychiatric beds, and short-term emergency room admissions are excluded. Infants under one year of age are also excluded from this surveillance.

The surveillance protocol for CDI can be downloaded as a PDF document