C. difficile
  • C. difficile: should I be worried?

What is C. difficile?

C. difficile, or Clostridium difficile, is a kind of bacteria that upsets the normal balance of healthy bacteria in the digestive system, causing diarrhea. It often affects people who have been taking antibiotics, especially "broad spectrum" ones that kill a wide variety of bacteria.

C. difficile has been around for a long time. A study of Quebec hospitals found a dramatically higher rate of death in people with the infection. Instead of the usual death rate of 1.5%, some hospitals had a death rate of 8.5% among those who become infected. Rates at which people become infected have also increased. Researchers worry that a new, more deadly strain of C. difficile has emerged.

What causes it?

C. difficile doesn't normally cause trouble for healthy people. However, for people taking antibiotics, it becomes a problem when it takes over from other "healthy" bacteria in your colon or large intestine, causing diarrhea and damaging the colon. Common culprits are amoxicillin, clindamycin, and a group of antibiotics known as the cephalosporins.

Why does it happen in hospitals and nursing homes?

Most of the cases of C. difficile have been reported in hospitals and nursing homes. Why? These are both places where patients commonly receive the "broad-spectrum" antibiotics that increase the risk of C. difficile infection. As well, C. difficile is often normally found in hospitals and nursing homes, and is easily spread from person to person through contaminated instruments and dirty hands.

What are the symptoms?

Symptoms of C. difficile infection may include watery diarrhea, diarrhea containing blood or mucus, abdominal pain and cramps, fever, chills, and fast heartbeat. In severe cases, this infection can be fatal.

How is it treated?

For mild cases, the usual treatment is to stop the antibiotics. The balance of healthy bacteria in the colon is usually restored, which gets rid of the problem. For more severe cases, the original antibiotics are stopped and new antibiotics, usually metronidazole or vancomycin, are started. These 2 antibiotics target C. difficile itself to help the body get rid of the infection. In very severe cases where antibiotics don't work, surgery may be needed.

How can I protect myself?

One way to avoid C. difficile infection is not to take antibiotics and to stay away from hospitals or nursing homes. However, that's not always possible or even practical.

Here are a few things you can do to stay safe:

  • Wash your hands thoroughly with soap and water after going to the washroom, before and after handling food or medications, before and after visiting people in the hospital, and before eating or taking medications by mouth.
  • If you are visiting someone in a hospital or nursing home, follow all precautions that the hospital staff recommends, including visiting restrictions and protective clothing.
  • If you think you may have a C. difficile infection, contact your doctor.

Here are the steps that hospitals and nursing homes take to reduce the risk of C. difficile:

  • Careful antibiotic prescribing practices: This means using antibiotics only when needed and choosing antibiotics that are better targeted to the bugs they are trying to kill.
  • Handwashing: Since C. difficile can be spread through contaminated hands, all staff and visitors should wash their hands properly before and after touching patients, going to the washroom, or handling food and medications.
  • Room cleaning and disinfection: C. difficile can be spread on dirty surfaces. Rooms and instruments need to be thoroughly cleaned and disinfected between people.
  • Isolation: People found to have C. difficile should be placed in isolation so that they do not infect others. Special precautions are taken when entering, leaving, and working in the isolation room.

Since the new strain was first reported, hospitals have taken action to limit the spread of C. difficile and cut down on infections. These steps, plus taking the precautions listed above, will help protect you from C. difficile.

Written and reviewed by the MediResource Clinical Team