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Clostridium difficile Infection

Clostridium difficile (C diff or C difficile) bacteria are harmful germs. They infect the intestinal tract. They can cause symptoms ranging from mild diarrhea to bad inflammation of the colon (large intestine). C difficile infection most often occurs during or after treatment with antibiotics. Anyone can become infected. But the risk is greatest for people in hospitals and nursing homes. This is because antibiotic use is common there. Germs also spread easily in these places. Here is more information about preventing the spread of this infection.

Closeup of hands being washed with soap and water.

What Causes C difficile Infection?

The digestive tract (gut) has hundreds of kinds of bacteria. Small amounts of C difficile are normal. Many of these bacteria are “good.” They help keep harmful bacteria like C difficile in check. When a person takes antibiotics, many of the normal, helpful bacteria in the gut die off. This may leave too few “good” bacteria. Harmful bacteria like C difficile may grow out of control. In hospitals and nursing homes, C difficile can travel from an infected patient to a noninfected patient. It travels on the hands of caregivers and visitors. It also can be on objects, such as bed rails, stethoscopes, and bedpans.

What Are the Symptoms of C difficile Infection?

People with C difficile infection often have no symptoms. Yet they can still pass the infection. Others do have symptoms. These include watery diarrhea, abdominal pain, and cramping. But they don’t get very ill. Some who are infected develop serious problems. They may have severe diarrhea, fever, and blood or pus in the stool. If symptoms appear, they often begin a few days to a week or more after antibiotics are started. But they may also appear weeks or even months later. If you have been given antibiotics and develop symptoms like those above, call the doctor right away.

How Is C difficile Infection Diagnosed?

To confirm the infection, a sample of stool is tested for toxins made by the bacteria. It is often diagnosed in the hospital. But symptoms can start once a patient is at home.

How Is C difficile Infection Treated?

  • The first step is to stop taking antibiotics. If they can’t be stopped, a different medication 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 healthy bacteria) may be given. They help restore a good 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 and alcohol. They can make symptoms worse. So can coffee, tea, milk, fruit juice, and colas.

  • Follow your health care provider’s instructions for when and what to eat.

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

  • Unless your health care provider tells you to do so, do not take medications for diarrhea.

  • Tell your health care 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. Giving antibiotics only when needed can help reduce C difficile infections.

  • Handwashing. Hospital staff wash their hands before and after treating each patient with C difficile infection. They also wash their hands after touching any surface that may be affected. Soap and water work better than alcohol-based hand cleaners.

  • Protective clothing. Health care 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, they may share a room only with others who have the same infection.

  • Thorough cleaning. Equipment and rooms 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

  • Take antibiotics only when you really need them. Antibiotics don’t help treat illnesses caused by viruses. This includes colds and the flu. Don’t ask for antibiotics from your doctor if he or she says they won’t work.

  • When you are given antibiotics, take them as directed. Don’t increase or decrease the dosage. Do not take them for shorter or longer than your doctor tells you to, even if you feel better.

  • You can try probiotic supplements or yogurt with healthy bacteria. Do this during and after antibiotic treatment. You can buy probiotic supplements at most natural foods stores and pharmacies.

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

How Family and Friends Can Help

In a hospital or care facility:

  • Wash your hands well before and after visiting someone who has C difficile infection. Use soap and water. Alcohol-based hand gels may not work against C difficile germs.

  • If the staff asks you to, wear gloves. Take any other steps you are asked to follow to help prevent infection.

At home:

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

  • Wash the patient’s clothes, bed linen, and towels separately. Use hot water. Use both detergent and liquid bleach.

  • Disinfect surfaces in the patient’s room. This includes the 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. Wash under nails, between fingers, and up the wrists.

  • Wash for at least 15 seconds to 20 seconds. Singing "Happy Birthday" or the "Alphabet Song" are examples of how long 15 seconds would be. Don’t just wipe. Scrub well.

  • Rinse. Let 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.


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