Clostridioides difficile

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

Clostridioides difficile (or C. difficile) is a type of bacteria (germ) that causes diarrhea. C. difficile can live naturally in the intestines (gut) of humans and not cause any problem. Sometimes changes in the gut lead the bacteria to produce toxins and then illness can develop.

Who gets C. difficile?

Individuals at the highest risk for C. difficile infection are people, especially older adults, who take antibiotics for a long time. Persons with underlying gastrointestinal conditions or prior gastrointestinal surgery, those with weakened immune systems or other chronic underlying health conditions, and persons who are frequently hospitalized are also at increased risk for C. difficile infection.

How is C. difficile spread?

The bacteria are passed in feces (stool). If feces gets on items or surfaces, such as by unclean hands touching them, then those items or surfaces become contaminated. Someone else can come along and touch a contaminated item or surface, pick up the bacteria, and pass the bacteria along to another person, item, or surface. People get the bacteria into their bodies by putting unclean hands in their mouths or other body sites, such as the eyes. It is important to wash hands often and properly and keep the environment clean; C. difficile can remain on items and surfaces for a long time and can be difficult to remove from the environment.

What are the symptoms of C. difficile infection?

Many people carry C. difficile in their bodies and on their skin without any symptoms. This is referred to as being “colonized.”  A person can be colonized for a long time and never get sick or get sick much later. The most common symptoms of a C. difficile infection include watery diarrhea, fever, loss of appetite, nausea, and belly pain and tenderness.

How soon after exposure do symptoms appear?

The exact timeframe is unknown, although it is thought to be less than 7 days.

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 relieve symptoms within two to three days. More powerful and appropriately targeted antibiotics are sometimes prescribed. In severe cases, surgery might be needed to remove the infected part of the intestines.

Transplanting stool from a healthy person to the colon of a patient with repeat C. difficile infections has been used as a successful treatment. These “fecal transplants” appear to be the most effective method for helping patients with repeat C. difficile infections, but the procedure is relatively new and not widely available.

How can C. difficile infection be prevented?

Patients with C. difficile should follow all instructions given by their healthcare 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. Everyone should be sure to take antibiotics as prescribed and wash hands often, especially after using the bathroom and before eating.

People who work in hospitals and other healthcare settings follow special infection control measures to prevent the spread of these bacteria. Special disinfectants are needed to remove C. difficile from items and surfaces. Healthcare providers wear a gown and gloves when caring for patients with C. difficile and practice frequent hand hygiene to limit the spread of C. difficile.

How can I get more information about C. difficile?

June 2023

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Last Updated: June 15, 2023