Clostridium difficile

What is Clostridium difficile (C. difficile or C. diff)? 

Clostridium difficile (or C. difficile) is a type of bacteria (germ) that causes diarrhea and is sometimes found naturally in the gut of humans. C. difficile bacteria can also produce spores (dormant bacteria) that make the organism very difficult to eliminate in the environment.

Who gets C. difficile

Individuals at the highest risk for C. difficile infection include those on antibiotic medications, persons with underlying gastrointestinal conditions or prior gastrointestinal surgery, individuals who are frequently hospitalized, and those who have weakened immune systems or other chronic underlying health conditions. When a person takes antibiotics, good germs that protect against infection are destroyed for several months. During this time, people can get sick if they are exposed to C. difficile because the body cannot fight off the C. difficile germs.

How is C. difficile spread? 

The bacteria are passed in feces (stool) and then can contaminate items or surfaces. If a person touches a contaminated item or surface, hands are then contaminated. The bacteria are spread if contaminated hands touch something that another person puts in the mouth. Direct contact with contaminated items (e.g., medical equipment) or environmental surfaces (e.g., toilets, bath tubs) can also spread the bacteria. It is important to wash hands often and properly and keep the environment clean; C. difficile spores can remain on surfaces for a long time.

What are the symptoms of C. difficile infection? 

Many people carry C. difficile germs in their bodies without any symptoms. This is called being “colonized”. A person may be colonized for a long time before getting sick or may never get sick. The most common symptoms of a C. difficile infection include watery diarrhea, fever, loss of appetite, nausea, and belly pain and tenderness. More serious infections can also develop in the intestine.

How soon after exposure do symptoms appear? 

This is unknown.

How is C. difficile infection diagnosed? 

Special laboratory tests of feces (stool) can be used to diagnose C. difficile infection.

What is the treatment for C. difficile infection? 

In some patients, stopping antibiotic treatment will help resolve symptoms of infection within two to three days. It also may be possible to treat a C. difficile infection with a more powerful and appropriately targeted antibiotic. In some severe cases, a person might have to have surgery to remove the infected part of the intestine.

How can C. difficile infection be prevented? 

Use of good infection prevention practices (such as enhanced environmental cleaning, wearing a gown and gloves when caring for patients with C. difficile, and frequent hand hygiene by healthcare workers) can limit the spread of C. difficile in healthcare settings. Patients with C. difficile should follow all instructions given by their care providers and keep their hands clean, especially after using the bathroom. Friends or family members visiting a patient with C. difficile should follow the healthcare facility’s recommended precautions.

How can I get more information about C. difficile

January 2013