Learning About Clostridium Difficile Infection

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What is Clostridium difficile?

Clostridium difficile (also called C. diff) is a type of bacteria that can cause swelling and irritation of the large intestine. This can cause diarrhea, fever, and belly cramps.

Infection by C. diff is most common in people who are taking antibiotics or who took them in the past few weeks. It is also more likely in older people and people who are getting chemotherapy for cancer. Though the infection can be mild, it can become serious, especially for people who have a weak immune system.

The large intestine normally contains many good bacteria that keep it healthy and don't cause disease. When you take an antibiotic to kill specific bacteria that are causing an illness, your antibiotic may also kill the good bacteria. This can allow C. diff bacteria to grow and release harmful toxins.

The inflammation of the large intestine, called colitis, is caused by these toxins. This is a serious infection that needs treatment. The toxins can also cause the colon to swell to many times its normal size. If that happens, it's very serious and needs emergency treatment.

If you are still taking an antibiotic, your doctor may have you stop taking it because it may have led to the C. diff infection. Your doctor may then give you a different antibiotic that targets C. diff.

How is it diagnosed?

Your doctor may think you have C. diff colitis if both of the following are true:

  • You are taking, or you recently took, antibiotics.
  • You have symptoms of the illness. These may include:
    • Watery diarrhea (which may contain blood or pus).
    • Swelling, cramps, pain, or tenderness in the belly.
    • Fever.
    • Dehydration.

To confirm the diagnosis, a sample of your stool will be tested. The test will check for the bacteria by looking for its DNA. Another test may be done to look for the toxins that C. diff produces.

Your doctor may look at the inside of your colon through a thin, lighted tube called a colonoscope. In the most serious cases, the doctor may see patches of yellow and white tissue on the inside of the colon.

How does C. diff get passed to other people?

C. diff can be passed from person to person. It can also be passed from person to object to person. It's important that your infection does not spread to other people. Preventing the spread of C. diff is a top health concern in hospitals and long-term care facilities.

If you have a C. diff infection, you can spread it if you don't wash your hands well enough with soap and water after you use the washroom. Anything you touch, like a door handle, bed rail, or phone, can then carry the bacteria. C. diff can live on objects for a very long time.

The infection spreads to other people when they touch an object that has C. diff on it and then use their hands to eat or rub their faces.

Health care workers can pass C. diff from room to room in a hospital or a long-term care facility. Visitors can also spread it.

How can you avoid spreading C. diff infection?

When you have C. diff, you and everyone around you must take special care to avoid spreading it. You must use extra care after you use the washroom.

The best way to prevent spreading the infection is to wash your hands well and often. The rubbing and rinsing action helps wash the bacteria from your skin.

  • Wash your hands with running water and soap.
  • Rub your hands together for at least 20 seconds.
  • Pay special attention to your wrists, the backs of your hands, between your fingers, and under your fingernails.
  • Don't touch the faucet with your hand. Use a paper towel to turn off the water.

Don't use an alcohol-based hand sanitizer instead of washing your hands with soap and water. Sanitizer will not kill C. diff.

In the hospital

  • Ask your nurse if visitors need to wear special gowns and gloves.
  • Remind your visitors to wash their hands before they visit and as they leave your room.
  • Expect the hospital staff to use extra precautions. That means following safe handwashing routines and wearing gloves and gowns. They may wear masks when cleaning.

If it seems that a staff person isn't being as careful as you expect, ask what steps the hospital uses to control the spread of your infection. This might help remind the person to be more careful.

At home

After your diarrhea is better, you are much less likely to spread a C. diff infection. But you still need to take extra care to keep your home clean.

  • Regularly clean washroom surfaces with a bleach solution to kill any C. diff spores. To dilute household bleach,follow the directions on the label.
  • Wash your hands often and well. This is most important after you use the washroom and before you make and eat food.
  • Remind everyone in your home to also wash their hands often.

If you start having diarrhea again, call your doctor or nurse call line right away. Your doctor will tell you when you no longer need to take special care to prevent spreading C. diff.

Follow-up care is a key part of your treatment and safety. Be sure to make and go to all appointments, and call your doctor or nurse call line if you are having problems. It's also a good idea to know your test results and keep a list of the medicines you take.

Where can you learn more?

Go to https://www.healthwise.net/patientEd

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