Clostridium difficile Infection

Clostridium difficile (often called C difficile) bacteria are harmful germs that infect the intestinal tract. They can cause symptoms ranging from mild diarrhea to severe inflammation of the colon (large intestine). C difficile infection usually occurs during or after treatment with antibiotics. Anyone can become infected. But the risk is greatest for people in hospitals and nursing homes where antibiotic use is common and germs spread easily. This sheet gives more information about C difficile infection and what hospitals are doing to prevent this growing problem.

What Causes C difficile Infection?

The digestive tract (gut) contains hundreds of kinds of bacteria. Small amounts of C difficile are normal. Many of these kinds of bacteria are “good,” helping keep harmful bacteria like C difficile in check. When a person takes antibiotics, many bacteria in the gut are destroyed. This may leave too few “good” bacteria, allowing harmful bacteria like C difficile to grow out of control. C difficile infection is common in hospitals and nursing homes. C difficile can travel from an infected patient to a non-infected patient on the hands of caregivers and visitors and on objects such as bed rails, stethoscopes, and bedpans.

What Are the Symptoms of C difficile Infection?

Many people with C difficile infection have no symptoms, yet they can pass along the infection. Others have a mild to moderate illness with watery diarrhea, abdominal pain, and cramping. And some people develop serious illnesses such as colitis (inflammation of the colon). These diseases can cause severe diarrhea, fever, and blood or pus in the stool. Symptoms of C difficile infection often begin a few days to a week or more after antibiotics are started. But they may also appear weeks or even months later.

How Is C difficile Infection Diagnosed?

If symptoms develop after leaving the hospital, call the doctor. Be sure to tell the doctor about the hospital stay and that antibiotics were taken. If C difficile infection is suspected, a sample of stool is tested for toxins produced by the bacteria.

How Is C difficile Infection Treated?

• The first step is to stop antibiotic therapy. If antibiotics can’t be stopped, a different antibiotic may be tried. In certain cases, an antibiotic directed at the C difficile infection may be given.

• Fluids are often given through an IV placed in the arm. This helps replace fluids lost through diarrhea.

• Probiotics (supplements of beneficial bacteria) may be given to help restore a healthy balance in the intestine.

• Surgery may be needed if treatment fails to cure severe symptoms.

Easing Symptoms of C difficile Infection

• Drink plenty of fluids to replace water lost through diarrhea. Plain water or clear soups are best. Avoid carbonated drinks, alcohol, coffee, tea, milk, fruit juice, and colas. These can make symptoms worse.

• Eat according to your healthcare provider’s instructions.

• Until the diarrhea clears up, avoid fruit and all dairy foods except yogurt. They can make diarrhea worse.

• Do not take over-the-counter diarrhea medications unless your healthcare provider tells you to do so.

• Tell your healthcare provider if symptoms return. Even after treatment, C difficile may come back.

Preventing C difficile Infection: What Hospitals and Nursing Homes Are Doing

Many hospitals and nursing homes take these steps to help prevent C difficile infections:

• Limiting use of antibiotics: Limiting antibiotic use as much as possible can help reduce C difficile infections.

• Handwashing: Hospital staff wash their hands before and after treating each patient who has C difficile infection. They also wash their hands after touching any surface that may be contaminated. Soap and water may be more effective than alcohol-based hand cleaners.

• Protective clothing: Healthcare workers wear gloves and a gown when entering the room of a patient with C difficile infection. They remove these items before leaving.

• Private rooms: People with C difficile are placed in private rooms or share a room with others who have the same infection.

• Thorough cleaning: Equipment and room surfaces are cleaned and disinfected daily.

• Education: Patients and visitors are shown the best ways to avoid infection.

Preventing C difficile Infection: What You Can Do

Wash your hands with soap and water before and after visiting a sick friend or family member. Alcohol-based hand gels may not work against C difficile germs.

• Take antibiotics only when you really need them. Keep in mind that antibiotics won’t help viral illnesses, such as colds and flu. Take all medications as directed. Don’t increase the dosage or take the medication longer than your doctor recommends.

• Consider taking probiotic supplements or eating yogurt (contains beneficial bacteria) before, during, and after antibiotic treatment. You can buy probiotic supplements at most natural foods stores and pharmacies.

• Wash your hands carefully after using the bathroom and before eating. Use plenty of soap and warm water. Alcohol-based hand gels may not kill C difficile germs.

How Family and Friends Can Help

In a hospital or care facility:

• Wash your hands thoroughly before and after visiting someone who has C difficile infection. If possible, use soap and water. Alcohol-based hand gels may not work against C difficile germs.

• Wear gloves or take other precautions if the hospital requests it.

At home:

• Wear gloves when caring for a family member with C difficile infection. Discard the gloves after each use. Then wash your hands well.

• Wash the patient’s clothing, bed linen, and towels separately in hot water with detergent and liquid bleach.

• Disinfect surfaces in the patient’s room, including phone, light switches, and remote controls.

Tips for Good Handwashing:

• Use warm water and plenty of soap. Work up a good lather.

• Clean the whole hand, under your nails, between your fingers, and up the wrists.

• Wash for at least 15 seconds. Don’t just wipe. Scrub well.

• Rinse, letting the water run down your fingers, not up your wrists.

• Dry your hands well. Then use a paper towel to turn off the faucet and open the door.