The doctor said I have C-diff: What is it?

Clostridium difficile

C-diff (or C. diff) is the common name for Clostridium difficile, a bacteria spread by fecal contamination. Some individuals carrying the bacteria do not get sick but can still spread the pathogen. Good hygiene is considered to be the best preventative route, with spread in healthcare settings becoming a concern. Severe and untreated C. diff infection can spread to the blood, resulting in the fatal condition known as sepsis.

Infection can be diagnosed using a stool sample, and antibiotics are the common treatment. However, prevention is much easier than treatment.

Basics about C. difficle

The elderly, hospitalized individuals, those who were previously infected with C. diff, and patients undergoing prolonged antibiotic use are at a higher risk of being infected. Some spread of the infection is via health care workers and due to the close space of nursing homes - contact with fecal contaminated material and then touching the face can cause infection. C. diff also often infects the gastrointestinal tract (intestines, bowel) after antibiotic use because of the loss of strains of bacteria that live symbiotically within the intestines but are killed by the antibiotics. The symbiotic bacteria aid in food digestion and normal functions without causing infection and their presence prevent infectious strains from gaining a foothold in the body. However, once they are gone, C. diff can more easily infect the intestines, where it grows and produces toxins that destroy the lining of the intestines. The damaged lining develops patches of inflammation, called colitis (inflammation of the colon). This damage causes diarrhea, loss of appetite, nausea, abdominal pain and tenderness, and fever.

 

Prevention of C. diff

Some individuals carrying the bacteria do not get sick but can still spread the pathogen. Prevention is easier than treatment. Healthy adults are usually not susceptible to C. difficile infection except with antibiotic resistant strains, which have more virulent toxins. Good hygiene is considered to be the best preventative route: regular handwashing with warm water and mild soap (not antibacterial soap) after using the restroom and before eating, proper sterilization of hospital instruments and surfaces, health care workers using disposable gloves and instruments; household surfaces in the kitchen and bathroom being washed with disinfectants on a regular basis, and avoiding unnecessary antibiotic use.

 

C. diff often causes illness after antibiotic use because the treatment kills off much of the natural flora (bacteria) in the intestines. The natural flora of the gastrointestinal tract aids in food digestion and normal bodily functions. These bacterial strains do not cause infection as they cooperate with the human body, known as symbiosis, but also prevent bacteria that do cause infection, such as C. diff, by keeping their numbers low. Wiping out these bacteria with antibiotics allows less symbiotic and more robust bacteria, like C. diff, to grow and infect.

 

Symptoms of C. diff

The symptoms of C. diff infection are caused by the toxins produced by growing C. difficile bacteria. The toxins destroy the intestinal lining, causing patches of inflammation inside the intestines.Symptoms of infection include diarrhea (for at least three times a day for two or more days), loss of appetite, nausea, abdominal pain and tenderness, and fever. Severe infection, or if an infection is left untreated and escalates, is often accompanied by blood in the stool. The infection can spread to the blood, resulting in sepsis, a condition that is very often fatal. However some infections are asymptomatic, but the bacteria can still be spread via the feces of the infected person.

 

An antibiotic resistant (clindamycin and erythromycin) strain of C. diff emerged in 2000, which produces more aggressive toxins and causes disease in healthy adults, who are normally not susceptible to C. diff infection. Severe and untreated C. diff infection can spread to the blood, resulting in the fatal condition known as sepsis. Blood in the stool is an indicator of this progression.

 

Diagnosis of C. diff infection

Diagnosis includes stool sample testing, and an infection is treated with antibiotics after discontinuing any current antibiotic therapy. A normal course of antibiotics lasts roughly 10 days. Multiple antibiotics are sometimes attempted before a response is seen. Other measures taken by a doctor may include probiotics to increase the growth of symbiotic bacteria and surgery to remove damaged portions of the intestine.

Preventing infection is easier than treating it.