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
  • People who have a 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 a patient may have. 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 environmental cleaning, 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 will never going be eradicated completely because the bacteria live in people’s guts and normally don’t cause illness. We only see illness when a person carrying the bug is exposed to antibiotics, killing the normal gut flora and allowing the C. difficile to grow and produce a toxin that causes the illness.

Even if the bug were eliminated from the hospital environment, it would be continuously reintroduced by new patients coming into the hospital and it survives 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 never be able to kill it all.

The focus needs to be on prevention. This includes using antibiotics wisely, 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.