Clostridioides difficile infection

Clostridioides difficile (C. difficile), formerly Clostridium difficile, is a bacterium that lives in the intestine. It infects the colon walls, causing health problems of varying severity. Certain healthy individuals can carry the bacteria without showing symptoms. Infection occurs if the bacteria proliferate. It is the most widespread infection in Canadian hospitals and the leading cause of infectious diarrhea in hospitalized patients.

Causes

C. difficile is found in feces. It is commonly spread by infected persons through hand contact. Direct contact (handshake, for example) contributes to spreading the bacteria. Given that C. difficile can live in the environment, any surface or object can harbour the bacteria (door knob, phone, etc.), thereby contaminating those who come into contact with infected surfaces.

The C. difficile bacterium is usually kept in check by other bacteria that live in the intestine and promote intestinal health. The normal bacterial flora in the intestine helps prevent C. difficile from multiplying and causing infection. Taking antibiotics, however, disturbs and reduces the bacteria normally found in the intestine, allowing C. difficile to multiply and increase its presence. As it multiplies, C. difficile produces a toxin that causes diarrhea in those who are infected.

Persons at Risk

Hospitalized individuals are among those who present the highest risk of contamination. Persons using antibiotics for any length of time or taking certain medications for stomach disorders also have a greater risk for infection. Healthy people are not usually vulnerable.

Symptoms

There are many symptoms of C. difficile infection. Here are some of the most common:

In rare cases, complications (serious intestinal inflammation, dehydration and colitis) can be fatal.

Treatment

When possible, discontinuing antibiotics is the first consideration. Treatment then involves taking a specific antibiotic to eliminate C. difficile.

If the infection comes back, the antibiotic treatment might be extended. There is also a treatment called "fecal transplant" when the infection recurs frequently. This technique involves collecting bowel movements from a healthy person and transplanting it into the intestine of the infected person.

Prevention

To prevent the spread of C. difficile, proper hand washing techniques are essential. Hands must be washed with soap and water in order to mechanically eliminate most bacteria and spores from contaminated hands. If you cannot have access to soap and water, the use of alcohol-based hand rubs is then recommended. However, be aware that these preparations are less effective as they do not destroy C. difficile spores. The use of a diluted bleach solution (1 part bleach for 10 parts water) is recommended to sanitize all objects that an infected person may have come into contact with. The infected person's clothing and bedding should be laundered in the washing machine at the highest possible temperature.

If taking antibiotics, it may be suggested that you take probiotics. Probiotics help regenerate the normal bacterial flora that protects the intestine, which may reduce the risk of C. difficile infection. The effectiveness of this combination, however, is not wholly accepted by the scientific community.