Clostridioides difficile [klos–TRID–e–OY-dees dif–uh–SEEL], commonly known as C. diff, is a bacterium (germ) that can cause severe diarrhea and inflammation of the large intestine (colitis). With an estimated half a million infections in the U.S. each year, these contagious bacteria can be life-threatening.
How Do You Get C. diff ?
C. diff is commonly found in the environment—the soil, air, and water. Outside the body, C. diff bacteria become dormant as spores that can survive on surfaces for weeks or months. The spores are inactive but become active after they are swallowed and get into your intestines, where they can release tissue-damaging toxins.
C. diff infection typically occurs while you’re taking antibiotics or not long after you’ve finished taking them. This is because antibiotics taken to fight bacterial infections anywhere in the body kill “bad” germs but can also get rid of too many beneficial bacteria in the intestine. This includes those beneficial bacterium that protect the body against things like C. diff infections. While some people “carry” these bacteria in their intestines but do not become ill, they can still spread the infection.
Typical Symptoms and Risk Factors for Infection
The symptoms of C. diff infection develop within a few days or up to several weeks after taking antibiotics. Symptoms may include:
- Watery diarrhea
- Stomach tenderness or pain
- Loss of appetite
The antibiotics most frequently associated with C. diff infection are clindamycin, fluoroquinolones, cephalosporins, and penicillins.
C. diff most commonly affects older adults in healthcare settings such as hospitals and long-term care facilities. About 200,000 people in the U.S. are infected with C. diff each year in a hospital or care setting. C. diff is more common in healthcare settings because people carrying C. diff are staying or being treated in these facilities.
How C. diff infection Spreads
C. diff spreads when people touch surfaces that are contaminated with stool from an infected person (skin, shared cups, toilets, sinks, telephones, handles, bedrails, bed linens, etc.) and don’t wash their hands adequately with soap and water after using the bathroom and before eating. HAND SANITIZER DOES NOT KILL C. diff SPORES!
Other risk factors include:
- Having a weakened immune system (e.g., people with HIV/AIDs, cancer, the elderly or those taking drugs that suppress the immune system, such as organ transplant patients)
- Having inflammatory bowel disease (IBD)
- Having chronic kidney disease
- Undergoing a gastrointestinal procedure or other abdominal surgery
- Having previous C. diff infection. Approximately 1 in 6 C. diff patients have a recurrence not long after finishing treatment (within 2-8 weeks).
Preventing C. diff Infection in Healthcare Facilities
To prevent the spread of C. diff in healthcare facilities and nursing homes, facilities must adhere to strict infection control measures for patients, residents, healthcare providers, and facility workers, as well as visitors and loved ones of patients and residents. These measures include:
- Rapid testing for C. diff, followed by isolation of infected persons
- Strict hand hygiene: washing hands thoroughly with soap and water
- Use of disposable gloves and gowns
- Thoroughly disinfecting all surfaces with cleaning products approved for killing C. diff spores on surfaces
Treatment and Risk of Recurrence
If you test positive for C. diff, you’ll usually be prescribed an antibiotic. Most patients see symptoms resolve after finishing the treatment. Even after recovery, however, you could be a carrier, and so you should continue to practice good hand hygiene to prevent spreading the infection.
Certain strains of this bacterium are resistant to the antibiotics usually used to treat it, leading to relapse and treatment failure. Studies have shown that fecal microbiota transplant with stool from a healthy donor is a treatment option for recurrent C. diff infection.
Quality of Life Significantly Impaired
Multiple studies have highlighted the burden of C. diff infection on the patient’s quality of life. An international survey among more than 350,000 individuals found that those who were currently undergoing treatment for C. diff, or had in the past, had much worse quality of life compared to those who had no history of the infection. They also reported lower work productivity and reduced daily activities compared to those who had never had the infection. Patients who had suffered from C. diff were 2.5-times more likely to be absent from work; even if present, their productivity loss was twice that of those without a history of infection.
Additionally, patients report both physical and psychological consequences of the infection—both when they had an active infection and even after undergoing treatment. Patients fear that their symptoms will not completely go away.
Here are some useful resources for additional information:
Jacqueline Syrop is a health editor and writer specializing in information for patients and their caretakers. You can find her on Linkedin.